MEDICARE: ANNE MARIE KHOURI 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
1	367500000X	Certified Registered Nurse Anesthetist	220889	NY

General Provider Information

NPI Number	:	1457379232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MARIE KHOURI CRNA

Provider Business Mailing Address
First Line	:	PO BOX 7096
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95267-0096
Country	:	US
Telephone Number	:	209-956-7725
Fax Number	:	209-956-7733

Provider Business Practice Location Address
First Line	:	9002 QUEENS BLVD
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	718-558-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/11/2026

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