Individual
KENDALL CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
462 FIRST AVE, NEW YORK, NY 10016-9196
(212) 562-5555
Mailing address
550 W 45TH ST APT 1218, NEW YORK, NY 10036-3799
(614) 323-0371
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
769434-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
769434
NY
367500000X
Certified Registered Nurse Anesthetist
76943401
NY
Other
Enumeration date
07/08/2020
Last updated
10/18/2022
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