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NPI Code Detail

MEDICARE: MARIO INGLESE C.R.N.A.

MEDICARE: MARIO INGLESE C.R.N.A.
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 Anesthetist390405NY

General Provider Information

NPI Number : 1740286574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO INGLESE C.R.N.A.
Provider Business Mailing Address
First Line : 575 LEXINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-423-0104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 12/11/2024

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