Provider Demographics
NPI:1821053687
Name:VAZIRI, IRINI (CRNA)
Entity Type:Individual
Prefix:
First Name:IRINI
Middle Name:
Last Name:VAZIRI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN568880367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7283632OtherAETNA-NON HMO
PA106614OtherGEISINGER
PA2620652000OtherINDEPENDENCE BLUE CROSS
PA50058188OtherCAPITAL BLUE CROSS
PAP00287187OtherRR MEDICARE
PA001783294OtherHIGHMARK
PA50058188OtherKEYSTONE HEALTH PLAN CENTRAL
PA1150073OtherAETNA-HMO
PA106614OtherGEISINGER