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Organization
QUALITY CERTIFIED REGISTERED NURSE ANESTHETIST PC
Active
Organization
QUALITY CERTIFIED REGISTERED NURSE ANESTHETIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MISSIG CRNA (CEO)
(631) 446-1190
Entity
Organization
Contact information
Practice address
5 5TH AVE, BAY SHORE, NY 11706-7368
(631) 446-1190
(631) 787-6538
Mailing address
5 5TH AVE, BAY SHORE, NY 11706-7368
(631) 446-1190
(631) 787-6538
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
446026
NY
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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