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Individual

MR. GREGORY J MAKUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-5118
(717) 782-5854
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN514477L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
076138
PA LICENSE
PA
01
MS1942927
HIGHMARK BS
PA
Enumeration date
12/01/2006
Last updated
01/28/2021
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