Individual
EVAN DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
43 NEW SCOTLAND AVE, ALBANY, NY 12208-3412
(518) 262-3125
Mailing address
33 TRADITIONAL LN, ALBANY, NY 12211-1951
(518) 860-2912
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
616410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616410
NY NURSING LICENSE NUMBER
NY
Enumeration date
10/08/2016
Last updated
10/08/2016
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