Individual
MARY E. DIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10021-4870
(212) 746-2846
Mailing address
525 E 68TH ST, NEW YORK, NY 10021-4870
(212) 746-2846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
039900
NY
Other
Enumeration date
06/12/2007
Last updated
12/17/2013
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