Basic Information
Provider Information
NPI: 1679845440
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAUNT
FirstName: TODD
MiddleName: ALAN
NamePrefix: MR.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOTHROP ST
Address2: SUITE 9055 FORBES TOWER
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber:  
Practice Location
Address1: 200 LOTHROP ST
Address2: SUITE 9055 FORBES TOWER
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/08/2012
LastUpdateDate: 02/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN581733PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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