Provider Demographics
NPI:1306352497
Name:BILLINGS, JASON ALLAN (CRNA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ALLAN
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:ALLAN
Other - Last Name:BILLINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:240 SURREY RD APT 10
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2949
Mailing Address - Country:US
Mailing Address - Phone:404-791-8711
Mailing Address - Fax:
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2508
Practice Address - Country:US
Practice Address - Phone:718-630-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY742001-1207L00000X
NY742001363AM0700X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical