Provider Demographics
NPI:1104812858
Name:LEWANDOWSKI, ANTHONY J (CRNA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN303498L163W00000X
PA044467367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2036431000OtherINDEP. BLUE CROSS
PA50016517OtherCAPITAL ADVANTAGE
PA82857OtherGEISINGER
PA1342819OtherKHP CENTRAL
PA9550501OtherAETNA
PA1343819OtherHIGHMARK
PA1027817890001Medicaid
PA11783684OtherCAQH
PA1343819OtherFIRST PRIORITY
PA1543163OtherGATEWAY
PA005972QCYMedicare PIN
PA1343819OtherHIGHMARK
PA9550501OtherAETNA