Healthcare Provider Details

I. General information

NPI: 1255603759
Provider Name (Legal Business Name): SHERILYN BATISTA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 NORTHFIELD RD
CORAM NY
11727-3147
US

IV. Provider business mailing address

6 NORTHFIELD RD
CORAM NY
11727-3147
US

V. Phone/Fax

Practice location:
  • Phone: 631-974-9777
  • Fax:
Mailing address:
  • Phone: 631-974-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number647501-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number123487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: