| Sophorn Mot, CRNA | |
|
111 S 11th St, Suite 8490, Philadelphia, PA 19107-4824 | |
| (215) 955-6161 | |
| (215) 923-5507 |
| Full Name | Sophorn Mot |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 111 S 11th St, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518248087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 26NR14106000 (New Jersey) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RN585927 (Pennsylvania) | Primary |
| Entity Name | Shriners Hospitals For Children |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1659615706 PECOS PAC ID: 9133031933 Enrollment ID: O20140508000878 |
| Mailing Address | Practice Location Address |
|---|---|
| Sophorn Mot, CRNA 111 S 11th St, Suite 8490, Philadelphia, PA 19107-4824 Ph: (215) 955-6161 | Sophorn Mot, CRNA 111 S 11th St, Suite 8490, Philadelphia, PA 19107-4824 Ph: (215) 955-6161 |
Victor Abarca, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5800 Ridge Ave., Philadelphia, PA 19128 Phone: 251-483-9900 | |
Rosabelle Mccullough, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, Dulles Bldg, Ste 680, Philadelphia, PA 19104 Phone: 215-349-8310 | |
Heather Moore, RN Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 10800 Knights Rd, Philadelphia, PA 19114 Phone: 215-612-4000 | |
Donna Simmers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2301 E Allegheny Ave, Philadelphia, PA 19134 Phone: 215-291-3000 | |
Catrina Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 Spruce St, Philadelphia, PA 19107 Phone: 215-829-5664 | |
Veronica Mooney, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 101 E Olney Ave, Suite 400, Philadelphia, PA 19120 Phone: 215-456-7000 Fax: 215-254-2599 | |
Lauren Bruce, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 E Olney Ave, Suite 400, Philadelphia, PA 19120 Phone: 215-456-7000 Fax: 215-254-2599 |