Provider Demographics
NPI:1679679013
Name:REST ASSURED, P.A.
Entity type:Organization
Organization Name:REST ASSURED, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:ROMANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:410-961-6774
Mailing Address - Street 1:11010 DOXBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1499
Mailing Address - Country:US
Mailing Address - Phone:410-961-6774
Mailing Address - Fax:443-325-5954
Practice Address - Street 1:11010 DOXBERRY CIR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:MD
Practice Address - Zip Code:21163-1499
Practice Address - Country:US
Practice Address - Phone:410-961-6774
Practice Address - Fax:443-325-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR078185367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9415009 00Medicaid