Provider Demographics
NPI:1730157520
Name:GATTO, CHARLES L (CRNA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:L
Last Name:GATTO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 PILOT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3724
Mailing Address - Country:US
Mailing Address - Phone:412-612-3181
Mailing Address - Fax:
Practice Address - Street 1:619 PILOT RD
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3724
Practice Address - Country:US
Practice Address - Phone:412-612-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN195164L367500000X
WV69582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019121400004Medicaid
WV3810007662Medicaid
OH2730307Medicaid
WVP00397828OtherRAILROAD MEDICARE
WVP00397828OtherRAILROAD MEDICARE
R06395Medicare UPIN