Provider Demographics
NPI:1356325492
Name:ALBANO, JOEL (CRNA)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ALBANO
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 1:150 S WARNER RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2826
Mailing Address - Country:US
Mailing Address - Phone:610-254-9500
Mailing Address - Fax:610-254-9501
Practice Address - Street 1:150 S WARNER RD
Practice Address - Street 2:SUITE 160
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2826
Practice Address - Country:US
Practice Address - Phone:610-254-9500
Practice Address - Fax:610-254-9501
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN344536L367500000X
NJ26NJ00260400367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101239021-0001Medicaid
NJ034042Medicare ID - Type Unspecified
PA101239021-0001Medicaid