Individual
FAITH UTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 466-8153
Mailing address
68 S SERVICE RD STE 350, MELVILLE, NY 11747-2358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
598248
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
598248
NY
Other
Enumeration date
12/15/2017
Last updated
08/08/2023
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