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MICHELLE CERASUOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7979
(215) 456-8539
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN627128
PA
367500000X
Certified Registered Nurse Anesthetist
130259
PA
367500000X
Certified Registered Nurse Anesthetist
26NJ01013700
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN627128
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7W4192
MEDICARE
PA
Enumeration date
07/03/2019
Last updated
11/03/2025
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