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Individual

ADA SPISAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
325 S BELMONT ST, YORK, PA 17403-2608
(717) 843-8623
Mailing address
3998 FAIR RIDGE DR, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1349A
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
RN250322L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000378010
ANTHEM PROVIDER #
KY
01
030670000
BLACK LUNG
KY
01
214953VKC
NOVITAS MEDICARE
PA
05
74013491
KY
01
C20882
CUMBERLAND HEALTHCARE INC
KY
01
P00294276
RRMCR
KY
01
P01312473
RAILROAD MEDICARE
PA
Enumeration date
02/14/2006
Last updated
04/09/2015
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