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NPI Code Detail

MEDICARE: JESSICA MARIE RAGUSO CRNA

MEDICARE: JESSICA MARIE RAGUSO 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 Anesthetist751026NY

General Provider Information

NPI Number : 1295428118
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE RAGUSO CRNA
Provider Business Mailing Address
First Line : 169 SWINNERTON ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10307-1633
Country : US
Telephone Number : 347-403-3233
Fax Number :
Provider Business Practice Location Address
First Line : 355 BARD AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-1699
Country : US
Telephone Number : 718-818-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2023
Last Update Date : 04/08/2026

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