Healthcare Provider Details

I. General information

NPI: 1407140288
Provider Name (Legal Business Name): DEEPA ARUNA MISIR CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARUNA DEEPA MISIR CRNA

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST ANESTHESIA DEPARTMENT M-324
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

575 LEXINGTON AVE DEPT M-324
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2949
  • Fax: 212-746-8563
Mailing address:
  • Phone: 212-746-2949
  • Fax: 212-746-8563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number477876-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: