National Provider Identifier

Gordon Dietz, CRNA

Gordon Dietz, CRNA is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist in Springville, NY and a listed phone number of (716) 592-2871.

NPI 1790730299Springville, NYCertified Registered Nurse Anesthetist

Profile Overview

NPI
1790730299
Provider Type
Individual
Primary Specialty
Certified Registered Nurse Anesthetist
Enumeration Date
May 23, 2006
Last Updated
September 16, 2011

Practice Location

  • 224 E Main St
  • Bertrand Chaffee Hospital
  • Springville, NY 14141-1443

Phone: (716) 592-2871

Specialties

  • Certified Registered Nurse Anesthetist (367500000X)
Full Record
NPI
1790730299
Entity Type
Individual
Last Name
Dietz
First Name
Gordon
Name Prefix
Mr.
Credential
CRNA
Mailing Street Address
224 E Main St
Mailing Address Line 2
Bertrand Chaffee Hospital
Mailing City
Springville
Mailing State
NY
Mailing ZIP Code
14141-1443
Mailing Country
US
Mailing Phone
(716) 592-2871
Mailing Fax
(716) 794-0025
Practice Street Address
224 E Main St
Practice Address Line 2
Bertrand Chaffee Hospital
Practice City
Springville
Practice State
NY
Practice ZIP Code
14141-1443
Practice Country
US
Practice Phone
(716) 592-2871
Practice Fax
(716) 794-0025
Enumeration Date
May 23, 2006
Last Updated
September 16, 2011
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Certified Registered Nurse Anesthetist (367500000X)
Other Identifiers
007496140 0004 (PA), 050514 (PA, Group Medicare #), RN326868L (PA, RN License PA)