| Mr Gordon Dietz, CRNA | |
|
224 E Main St, Bertrand Chaffee Hospital, Springville, NY 14141-1443 | |
| (716) 592-2871 | |
| (716) 794-0025 |
| Full Name | Mr Gordon Dietz |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 224 E Main St, Springville, New York |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790730299 | NPI | - | NPPES |
| 007496140 0004 | Medicaid | PA | |
| 050514 | Other | PA | GROUP MEDICARE # |
| RN326868L | Other | PA | RN LICENSE PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R103713 (Maryland) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gordon Dietz, CRNA 224 E Main St, Bertrand Chaffee Hospital, Springville, NY 14141-1443 Ph: (716) 592-2871 | Mr Gordon Dietz, CRNA 224 E Main St, Bertrand Chaffee Hospital, Springville, NY 14141-1443 Ph: (716) 592-2871 |
Lori Ann Baker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: Bertrand Chaffee Hospital, 224 East Main Street, Springville, NY 14141 Phone: 716-592-2871 Fax: 716-794-0025 |