Individual
KRISTINA MASSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14280400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN574323
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NR14280400
STATE MEDICAL LICENSE NUMBER
NJ
01
—
RN574323
RN LICENSE
PA
Enumeration date
12/28/2011
Last updated
05/16/2018
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