Basic Information
| Provider Information | |||||||||
| NPI: | 1346235389 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROUPAS | ||||||||
| FirstName: | GIACINTA | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 396 WELSH RD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGDON VALLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190066440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2672424126 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 COOPER PLZ | ||||||||
| Address2: | DEPT OF ANESTHESIA | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422425 | ||||||||
| FaxNumber: | 8569688239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 08/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN512303L | PA | N | Nursing Service Providers | Registered Nurse | 367500000X | 053601 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 053601 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 1377359 | 01 | PA | HIGHMARK | OTHER | 2069051000 | 01 | PA | INDEP. BLUE CROSS | OTHER | 82830 | 01 | PA | GEISINGER | OTHER | 1377359 | 01 | PA | KHP CENTRAL | OTHER | 430070724 | 01 | PA | RAIL ROAD | OTHER | 50003129 | 01 | PA | CAPITAL ADVANTAGE | OTHER |