Provider Demographics
NPI:1447695135
Name:HILLMONT GI CRNA
Entity type:Organization
Organization Name:HILLMONT GI CRNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-402-0800
Mailing Address - Street 1:1811 BETHLEHEM PIKE
Mailing Address - Street 2:SUITE C-300
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1111
Mailing Address - Country:US
Mailing Address - Phone:215-402-0800
Mailing Address - Fax:215-402-0449
Practice Address - Street 1:1811 BETHLEHEM PIKE
Practice Address - Street 2:SUITE C-300
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-402-0800
Practice Address - Fax:215-402-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty