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NPI Code Detail

MEDICARE: ATHENA KERIN

MEDICARE:   ATHENA  KERIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist Assistant535903-1NY
2367500000XCertified Registered Nurse Anesthetist535903NY

General Provider Information

NPI Number : 1396155883
Entity Type Code : Individual
Provider Name (Legal Business Name) : ATHENA KERIN
Provider Business Mailing Address
First Line : 2 CATHARINE ST
Second Line : P O BOX 550
City : POUGHKEEPSIE
State : NY
Zip : 12601-3100
Country : US
Telephone Number : 845-790-2661
Fax Number : 845-790-2675
Provider Business Practice Location Address
First Line : 5000 AVENUE K
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-2202
Country : US
Telephone Number : 718-250-8259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2014
Last Update Date : 05/01/2018

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Directions to “ ATHENA KERIN ” Practice Location

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