Individual
MR. JAMES J PRUDENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
451 W CHEW ST, SUITE 409, ALLENTOWN, PA 18102-3472
(610) 770-3130
(610) 770-3452
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(610) 954-5810
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN247428L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0721521000
IBC
—
01
—
50049408
CBC
—
Enumeration date
11/08/2005
Last updated
05/06/2020
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