Basic Information
| Provider Information | |||||||||
| NPI: | 1770737611 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GNOLFO | ||||||||
| FirstName: | JOSEPH | ||||||||
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| NameSuffix: | III | ||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | STONY BROOK UNIVERSITY MEDICAL CTR | ||||||||
| Address2: | HSC LEVEL 4 - ROOM 060 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERSITY MEDICAL CTR | ||||||||
| Address2: | HSC LEVEL 4 - ROOM 060 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2008 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 081117 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 543496 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.