Individual
GARY SEBASTIANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1800 MULBERRY 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
RN319278L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073795000002
—
PA
Enumeration date
06/15/2006
Last updated
04/02/2008
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