Individual
MRS. JOANNE DILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 CAPITAL WAY, 2ND FLOOR ANESTHESIA OFFICES, PENNINGTON, NJ 08534-2520
(609) 396-4700
Mailing address
804 SCOTT NIXON MEMORIAL DRIVE, AUGUSTA, GA 30909-2464
(800) 394-4445
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00267300
NJ
367500000X
Certified Registered Nurse Anesthetist
RN327603L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076790Q1R
READING MEDICARE
PA
01
—
115406RVB
NATIONAL GOVERNMENT SERVICES (NJ EMPIRE)
NJ
Enumeration date
10/12/2005
Last updated
08/28/2012
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