Individual
MARY B. DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
70 DUBOI STREET, ST. LUKES HOSPITAL, NEWBURGH, NY 12550
(845) 561-4400
Mailing address
P.O. BOX 550, 2 CATHARINE STREET, MID-HUDSON ANETHESIOLOGIST, PC, POUGHKEEPSIE, NY 12602
(866) 885-2318
(845) 790-2675
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
400637
NY
367500000X
Certified Registered Nurse Anesthetist
400637-1
NY
367500000X
Certified Registered Nurse Anesthetist
RN357926L
PA
Other
Enumeration date
07/13/2006
Last updated
11/08/2019
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