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Individual

CHARLES E. HUCKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-512651-L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
052618
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1027807630001
PA
01
11803028
CAQH
PA
01
1478124
HIGHMARK
PA
01
1581510
GATEWAY
PA
01
2169343000
IBC
PA
01
3659
GEISINGER
PA
01
50056826
CAPITAL ADVANTAGE
PA
01
7546776
AETNA
PA
Enumeration date
12/15/2005
Last updated
03/25/2013
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