Individual
DEBORAH SUDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 346-7797
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5102
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
048086
PA
367500000X
Certified Registered Nurse Anesthetist
405796
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430063191
RR MEDICARE
PA
Enumeration date
11/29/2005
Last updated
08/13/2020
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