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NPI Code Detail

MEDICARE: MARCO PEREZ CRNA

MEDICARE: MARCO PEREZ CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist499979NY

General Provider Information

NPI Number : 1225169964
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCO PEREZ CRNA
Provider Business Mailing Address
First Line : 600 FRANKLIN AVE
Second Line : UNIT 7771
City : GARDEN CITY
State : NY
Zip : 11530-6844
Country : US
Telephone Number : 516-945-3000
Fax Number : 516-945-3131
Provider Business Practice Location Address
First Line : 2215 BURDETT AVE
Second Line :
City : TROY
State : NY
Zip : 12180-2475
Country : US
Telephone Number : 518-525-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 01/17/2024

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