John Amico, CRNA
Nurse Anesthetist, Certified Registered in Wilkes Barre, PA. Individual provider (NPI-1).
NPI number1760402994
StatusActive
Last updated in NPPESMar 19, 2015
Details
- NPI
- 1760402994
- Entity type
- Individual (NPI-1)
- Name
- John Amico
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 20, 2006
- Last updated
- Mar 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN523008L | PA | Yes |
Practice location
575 N River StWilkes Barre, PA 18702-2634
Phone 570-829-8111
Mailing address
3998 Fair Ridge DrSte 300
Fairfax, VA 22033-2907
Phone 703-293-9590 · Fax 703-293-9592
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