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Individual

JOHN E KRESGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
285 DAVIDSON AVE STE 204, SOMERSET, NJ 08873-4153
(732) 271-1400
(732) 271-3544
Mailing address
434 DANIEL ST, ALLENTOWN, PA 18104-8512
(610) 530-1891
(610) 530-0844

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-324043-L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
048901
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018603100007
PA
01
11453892
CAQH
PA
01
1337989
HIGHMARK
PA
01
1544464
GATEWAY
PA
01
2030781000
IBC
PA
01
50026714
CAPITAL ADVANTAGE
PA
01
7312259
AETNA
PA
01
77537
GEISINGER
PA
Enumeration date
06/24/2005
Last updated
07/08/2019
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