Healthcare Provider Details

I. General information

NPI: 1184803454
Provider Name (Legal Business Name): SHARON I BELL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PROSPECT AVE
SYRACUSE NY
13203-1807
US

IV. Provider business mailing address

301 PROSPECT AVE
SYRACUSE NY
13203-1807
US

V. Phone/Fax

Practice location:
  • Phone: 315-448-5440
  • Fax: 315-472-5010
Mailing address:
  • Phone: 315-448-5440
  • Fax: 315-472-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number483379-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: