Provider Demographics
NPI:1922198738
Name:JURASINSKI, ROBERT S (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:JURASINSKI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-963-6888
Mailing Address - Fax:856-968-8366
Practice Address - Street 1:900 CENTENNIAL BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4689
Practice Address - Country:US
Practice Address - Phone:856-325-6505
Practice Address - Fax:856-325-6515
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNR63015367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ009221 CK2Medicare PIN