Individual
KATIE ELIZABETH MAYBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457
(718) 466-8153
Mailing address
14 SCHOOL ST, RONKONKOMA, NY 11779-2210
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
558973
NY
367500000X
Certified Registered Nurse Anesthetist
RN2291273
MA
Other
Enumeration date
07/21/2016
Last updated
03/17/2018
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