Individual
BERNADETTE S. STA MARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
350 ENGLE STREET, ENGLEWOOD, NJ 07631
(201) 894-3322
(201) 894-0585
Mailing address
375 ENGLE STREET, ENGLEWOOD, NJ 07631
(201) 871-6073
(201) 655-6159
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR11075700
NJ
367500000X
Certified Registered Nurse Anesthetist
46838001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00833003
RAILROAD MEDICARE
NJ
Enumeration date
01/09/2007
Last updated
01/22/2019
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