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General NPI Number Information
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NPI Number | 1497029730
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Entity Type | Individual
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Provider Name | VANESSA QUEZADA TAHA CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 118 N BEDFORD RD
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City | MOUNT KISCO
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State | NY
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Zip | 10549-2553
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Country | US
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Telephone | 800-362-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SHADY BROOK CT
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City | WATCHUNG
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State | NJ
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Zip | 07069-6137
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Country | US
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Telephone |
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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 | 89166
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License Number State | NJ
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