Individual
SAMANTHA J RUTKOSKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN556259
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
90621
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027809600001
—
PA
01
—
12389010
CAQH
PA
01
—
1608903
GATEWAY
PA
01
—
1962763995
GEISINGER
PA
01
—
2707202
FIRST PRIORITY
PA
01
—
3881804000
IND. BLUE CROSS
PA
01
—
50108906
CAPITAL ADVANTAGE
PA
01
—
9761876
AETNA
PA
Enumeration date
06/06/2012
Last updated
03/25/2013
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