Healthcare Provider Details

I. General information

NPI: 1417085655
Provider Name (Legal Business Name): JOYLIN P PRIMUS-ARMSTRONG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ROUTE 59 SUITE 105
SUFFERN NY
10901-4927
US

IV. Provider business mailing address

19 TRAILSIDE PL
NEW CITY NY
10956-1312
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-5770
  • Fax: 845-357-8263
Mailing address:
  • Phone: 845-638-0227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number392003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: