Beredo, Michael D.

Beredo, Michael D. is an individual health care provider with primary practice located at 1 Guthrie Sq , Sayre PA 18840-1625. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Beredo, Michael D. can be contacted via phone (570) 888-5858.

Contact Information

Primary practice address
1 Guthrie Sq Sayre PA 18840-1625
Phone: (570) 888-5858
Fax: (570) 887-4464
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN542206 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 538854-1 New York

Profile Details

NPI number 1033188990
LBN Legal business name Beredo, Michael D.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jun 22nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033188990 NPPES
New York Other CC8362 RR MEDICARE GROUP
New York Other P00379063 RR MEDICARE GROUP
New York Other 430078581 RR MEDICARE GROUP
New York Other GU039832 RR MEDICARE GROUP
New York Other CC9269 RR MEDICARE GROUP

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