Basic Information
| Provider Information | |||||||||
| NPI: | 1306879648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PISONI | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | |||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4372 ROUTE 6 | ||||||||
| Address2: | |||||||||
| City: | KANE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167353060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148374550 | ||||||||
| FaxNumber: | 8148377992 | ||||||||
| Practice Location | |||||||||
| Address1: | 4372 ROUTE 6 | ||||||||
| Address2: | |||||||||
| City: | KANE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167353060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148374550 | ||||||||
| FaxNumber: | 8148377992 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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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 | RN166683L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 317053 | 01 | PA | UPMC BLK 33 PIN | OTHER | DD4802 | 01 | PA | PALMETTO GBA BLK 33 GRP | OTHER | P00231151 | 01 | PA | PALMETTO GBA BLK 33 PIN | OTHER | S56043 | 01 | PA | COMMERCIAL BLK 33 PIN | OTHER | 1530246 | 01 | PA | BLUE SHIELD BLK 33 PIN | OTHER | 1520056 | 01 | PA | BLUE SHIELD BLK 33 GRP | OTHER | 0019607640001 | 05 | PA | MEDICAID | 0019612980001 | 05 | PA | MEDICAID |