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Individual

MICHAEL SQUILLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, CRNA

Contact information

Practice address
7600 CENTRAL AVE, PHILADELPHIA, PA 19111-2442
(215) 728-2000
Mailing address
325 CHESTNUT ST STE 210, PHILADELPHIA, PA 19106-2602
(267) 322-7701

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN512924L
PA

Other

Enumeration date
09/09/2015
Last updated
09/09/2015
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