Individual
JAIME MOCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-5209
Mailing address
66 POWERHOUSE RD, FL 3, ROSLYN HTS, NY 11577-1324
(516) 626-6366
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R149525
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404267100
—
MD
01
—
454MI518
TRAILBLAZER
MD
Enumeration date
06/30/2005
Last updated
11/13/2008
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