Individual
ALEXANDRA MAE BONTUYAN FIDELLAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2323
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2323
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
676236
NY
Other
Enumeration date
06/28/2021
Last updated
06/06/2024
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