Provider Demographics
NPI:1952602799
Name:OSSIANDER, JOSEPH P (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:OSSIANDER
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 1:1245 S CEDAR CREST BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-529315163W00000X
PARN529315L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2548496OtherHIGHMARK
PA2548496OtherFIRST PRIORITY
PA1593163OtherGATEWAY
PA9638701OtherAETNA
PA2031873000OtherIND. BLUE CROSS
PA1027794030001Medicaid
PA12170812OtherCAQH
PA143674OtherGEISINGER
PA50096757OtherCAPITAL ADVANTAAGE
PA50096757OtherCAPITAL ADVANTAGE
PA2031873000OtherIND. BLUE CROSS
PA206752QCYMedicare PIN