Provider Demographics
NPI:1811407935
Name:LOSCO, BRIDGET NORA (CRNA)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:NORA
Last Name:LOSCO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:NORA
Other - Last Name:WACLAWIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:30 W FRONT ST APT C
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1657
Mailing Address - Country:US
Mailing Address - Phone:732-492-4794
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644823-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered