Individual
MR. STANISLAV ERENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7390
Mailing address
74A PASSAIC AVE, SUMMIT, NJ 07901-1228
(718) 207-3697
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NJ00892700
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
585363
NY
Other
Enumeration date
12/01/2011
Last updated
06/03/2019
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