Provider Demographics
NPI:1770543662
Name:PINILLA, DREW STEWART (CRNA)
Entity type:Individual
Prefix:MR
First Name:DREW
Middle Name:STEWART
Last Name:PINILLA
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3027
Practice Address - Country:US
Practice Address - Phone:540-316-5703
Practice Address - Fax:540-316-5701
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC221334367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1770543662Medicaid