Healthcare Provider Details

I. General information

NPI: 1932435591
Provider Name (Legal Business Name): KEARA ANNE CAHILL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 01/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

6 RIDGEDELL AVE
HASTINGS ON HUDSON NY
10706-1410
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-6865
  • Fax:
Mailing address:
  • Phone: 914-325-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number083843
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: