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Individual

MARK TRENTLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1822 JMULBERRY ST, SCRANTON, PA 18510
(570) 346-7797
(570) 342-9802
Mailing address
PO BOX 797, SCRANTON, PA 18501
(570) 346-7797
(570) 342-9802

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
051661
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0076378100002
PA
Enumeration date
01/24/2006
Last updated
04/02/2008
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