Individual
NICOLA D. DISANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5039 SWAMP RD, 406, FOUNTAINVILLE, PA 18923-9667
(215) 348-1523
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN535251
PA
Other
Enumeration date
02/24/2009
Last updated
08/13/2009
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