Individual
MARK A KANTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
118 NATURE PARK RD STE 200, GREENSBURG, PA 15601-6960
(412) 359-3155
(412) 359-3483
Mailing address
4727 FRIENDSHIP AVE, SUITE, PITTSBURGH, PA 15224-1779
(412) 235-5877
(412) 235-5851
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN573756
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12078239
CAQH
—
01
—
142827
MEDICARE PTAN
PA
Enumeration date
09/29/2008
Last updated
07/03/2024
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