Healthcare Provider Details

I. General information

NPI: 1992221956
Provider Name (Legal Business Name): KRISTIN ANNA SKORNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 08/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

27 HOMER AVE
LARCHMONT NY
10538-1612
US

V. Phone/Fax

Practice location:
  • Phone: 914-319-6110
  • Fax:
Mailing address:
  • Phone: 914-319-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number645945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: