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: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 LAFAYETTE AVE
SUFFERN NY
10901-4812
US

IV. Provider business mailing address

255 LAFAYETTE AVE FL 2
SUFFERN NY
10901-4812
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-5039
  • Fax:
Mailing address:
  • Phone: 845-368-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number315057
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: