Healthcare Provider Details

I. General information

NPI: 1679694111
Provider Name (Legal Business Name): DANIEL CURILLA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BEEKMAN ST
PLATTSBURGH NY
12901-1438
US

IV. Provider business mailing address

PO BOX 2846
PLATTSBURGH NY
12901-0258
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-7900
  • Fax: 518-562-7933
Mailing address:
  • Phone: 518-562-7900
  • Fax: 518-562-7933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number544510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: