Individual
MRS. MANJJU AGNES PULICKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
344 MAIN ST, SUITE 104, MT. KISCO, NY 10549
(914) 242-3652
(914) 244-8983
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NJ00321900
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
597810
NY
Other
Enumeration date
03/04/2011
Last updated
03/03/2016
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