Individual
JOHN AMICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
575 N RIVER ST, WILKES BARRE, PA 18702-2634
(570) 829-8111
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2907
(703) 293-9590
(703) 293-9592
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN523008L
PA
Other
Enumeration date
07/20/2006
Last updated
03/19/2015
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