Basic Information
| Provider Information | |||||||||
| NPI: | 1386648368 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARCOSKI | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | MIERAU | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 HILLCREST DR | ||||||||
| Address2: | |||||||||
| City: | GOULDSBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184249419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708421254 | ||||||||
| FaxNumber: | 5708425878 | ||||||||
| Practice Location | |||||||||
| Address1: | 425 BRIGHTON ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109545810 | ||||||||
| FaxNumber: | 6109545480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2005 | ||||||||
| LastUpdateDate: | 01/16/2008 | ||||||||
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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 | 367500000X | RN263770L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.