Active NPI
Ed J Destefano, CRNA
- Certified Registered Nurse Anesthetist
- Philadelphia, PA
National Provider Identifier
1629141544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN259564L
- Practice address
- 777 Appletree St
7TH Floor
Philadelphia, PA 19106-1526 - Phone
- (856) 356-4025
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN259564L | PA | Primary |
Addresses
Primary practice location
777 Appletree St
7TH Floor
Philadelphia, PA 19106-1526
Mailing address
601 Chapel Ave E
Cherry Hill, NJ 08034-1454
Phone (856) 356-4025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN259564L | PA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1629141544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CHAPEL AVE E",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080341454",
"telephone_number": "856-356-4025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 APPLETREE ST",
"address_2": "7TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191061526",
"telephone_number": "856-356-4025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFANO",
"first_name": "ED",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN259564L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.