Individual
EMERSON MOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
560 W 168TH ST, NEW YORK, NY 10032-3917
(212) 305-4318
Mailing address
11 MILLER PL, VALLEY STREAM, NY 11580-2518
(347) 881-6618
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
675716
NY
Other
Enumeration date
02/23/2019
Last updated
10/02/2020
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