Basic Information
Provider Information
NPI: 1972820538
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIULIANI
FirstName: LESLIE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: JOSEPH
OtherFirstName: LESLIE
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 828962
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191820001
CountryCode: US
TelephoneNumber: 5177876440
FaxNumber:  
Practice Location
Address1: 130 S BRYN MAWR AVE
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103121
CountryCode: US
TelephoneNumber: 6105263000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/22/2010
LastUpdateDate: 04/26/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN563197PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home