Individual
MICHAEL KENNETH MASSERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
STONY BROOK UNIVERSITY MEDICAL CENTER, HSC LEVEL 4 - ROOM 060, STONY BROOK, NY 11794-8480
(631) 444-2975
Mailing address
STONY BROOK UNIVERSITY MEDICAL CENTER, HSC LEVEL 4 - ROOM 060, STONY BROOK, NY 11794-8480
(631) 444-2975
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
431879
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
686773
NY
Other
Enumeration date
02/25/2019
Last updated
03/12/2025
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