Healthcare Provider Details

I. General information

NPI: 1831623099
Provider Name (Legal Business Name): CYNTHIA JOSEPH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIDGEPORT HOSPITAL-ANESTHESIA DEPARTMENT 267 GRANT STREET
BRIDGEPORT CT
06610
US

IV. Provider business mailing address

7365 MAIN ST # 310
STRATFORD CT
06614-1300
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-3801
  • Fax:
Mailing address:
  • Phone: 203-384-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7226
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: