Healthcare Provider Details
I. General information
NPI: 1447251954
Provider Name (Legal Business Name): RENEE MONTS-THOMPSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 N MIDLAND AVE NYACK HOSPITAL
NYACK NY
10960-1912
US
IV. Provider business mailing address
43 KENSICO DR 2ND FLOOR
MOUNT KISCO NY
10549-1009
US
V. Phone/Fax
- Phone: 845-348-2862
- Fax:
- Phone: 914-666-8866
- Fax: 914-666-6777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 315057 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: