Provider Demographics
NPI:1295366623
Name:CERAMI, JON (CRNA)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:CERAMI
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:CWN L-1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-7459
Mailing Address - Fax:617-277-2192
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:CWN L-1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-7459
Practice Address - Fax:617-277-2192
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02265367500000X
MARN2324186367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered