Individual
SIARHEI MIKHAILOUSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
111 HOSPITAL DR, UTICA, NY 13502-2517
(315) 917-7263
Mailing address
111 HOSPITAL DR., ATTN: CREDENTIALING, UTICA, NY 13502
(315) 801-8488
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN724693
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
638247
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN724693
PA RN LICENSE
PA
Enumeration date
07/13/2021
Last updated
10/23/2024
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