Individual
KEREN RAE DUMASLAN MANACOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
43 NEW SCOTLAND AVE, ALBANY, NY 12208-3478
(518) 262-4000
Mailing address
24 NORTH ST, ALBANY, NY 12205-3330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
665841-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
138531
NY
Other
Enumeration date
09/20/2021
Last updated
07/15/2022
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