Individual
MARIELLE SOEPRONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6840
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-6840
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
574671
NY
Other
Enumeration date
08/04/2009
Last updated
10/14/2015
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