Provider Demographics
NPI:1790970382
Name:FEUERSTEIN, DAWN M (CRNA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:FEUERSTEIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1245 S CEDAR CREST BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN539328163W00000X
PA078129367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110294OtherGEISINGER
PA1579547OtherGATEWAY
PA1027800390001Medicaid
PA1989741OtherFIRST PRIORITY
PA9335445OtherAETNA
PA2864851000OtherIBC
PA11803042OtherCAQH
PA1989741OtherHIGHMARK
PA50072664OtherCAPITAL ADVANTAGE
PA1027800390001Medicaid
PAP00613625Medicare PIN