Provider Demographics
NPI:1124052378
Name:APRILLIANO, GREGORY ROBERT (CRNA, APRN)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:ROBERT
Last Name:APRILLIANO
Suffix:
Gender:M
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1543
Mailing Address - Country:US
Mailing Address - Phone:603-692-3166
Mailing Address - Fax:306-692-3168
Practice Address - Street 1:255 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1543
Practice Address - Country:US
Practice Address - Phone:603-692-3166
Practice Address - Fax:306-692-3168
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH052768-23363L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434695199Medicaid
NH30344241Medicaid
ME434695199Medicaid