Individual
ERIC JULIYANTO RUSAIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
324045
AZ
Other
Enumeration date
05/17/2024
Last updated
08/27/2025
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