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General NPI Number Information
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NPI Number | 1083844021
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Entity Type | Individual
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Provider Name | TERESA CRAVEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 27005 76TH AVE DEPT OF ANESTHESIA
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 516-945-3000
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Fax | 516-945-3131
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Provider Business Mailing Address
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Address Line | 66 POWERHOUSE RD 3RD FL
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1372
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Country | US
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Telephone | 516-945-3000
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Fax | 516-945-3131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 493328
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License Number State | NY
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