Provider Demographics
NPI:1316128960
Name:BERIS, ANDREW A (CRNA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:A
Last Name:BERIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:A
Other - Last Name:BERIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:224 W EXCHANGE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1726
Mailing Address - Country:US
Mailing Address - Phone:330-344-7040
Mailing Address - Fax:330-344-1714
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:330-344-7040
Practice Address - Fax:330-344-1714
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN306552367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000699116OtherANTHEM
OH2820693Medicaid
OH8241009Medicare PIN