Individual
MR. GORDON DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
224 E MAIN ST, BERTRAND CHAFFEE HOSPITAL, SPRINGVILLE, NY 14141-1443
(716) 592-2871
(716) 794-0025
Mailing address
224 E MAIN ST, BERTRAND CHAFFEE HOSPITAL, SPRINGVILLE, NY 14141-1443
(716) 592-2871
(716) 794-0025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R103713
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007496140 0004
—
PA
01
—
050514
GROUP MEDICARE #
PA
01
—
RN326868L
RN LICENSE PA
PA
Enumeration date
05/23/2006
Last updated
09/16/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us