Healthcare Provider Details

I. General information

NPI: 1386645216
Provider Name (Legal Business Name): JANET JOHANNA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E POST RD
WHITE PLAINS NY
10601-4699
US

IV. Provider business mailing address

26 HIGHLAND AVE
EASTCHESTER NY
10709-3633
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-1281
  • Fax:
Mailing address:
  • Phone: 914-227-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number360368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: