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General NPI Number Information
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NPI Number | 1487029005
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Entity Type | Individual
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Provider Name | GABRIELLA REZNIK CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 692 NEW HEMPSTEAD RD
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City | SPRING VALLEY
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State | NY
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Zip | 10977-1738
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Country | US
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Telephone | 347-723-1934
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Fax |
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Provider Business Mailing Address
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Address Line | 558 LANGLEY AVE
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2926
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Country | US
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Telephone | 347-723-1934
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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 | 700841
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License Number State | NY
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