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General NPI Number Information
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NPI Number | 1295625051
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Entity Type | Individual
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Provider Name | ADRIAN RICHARD ANDERSON AGACNP-CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 27005 76TH AVE
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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 | 718-470-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3249 GRISWOLD AVE
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City | BRONX
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State | NY
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Zip | 10465-1379
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Country | US
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Telephone | 347-453-4268
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 712339
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License Number State | NY
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