Individual
MR. GERALD F CUSIMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3198
(570) 321-2385
(570) 321-2479
Mailing address
1201 GRAMPIAN BLVD, SUITE 1K, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN265536L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073690760002
—
PA
Enumeration date
09/20/2006
Last updated
02/23/2012
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