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NPI Code Detail

MEDICARE: ELIZABETH GUILLAUME CRNA

MEDICARE: ELIZABETH GUILLAUME 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
1163W00000XRegistered Nurse364933-1NY

General Provider Information

NPI Number : 1912907221
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH GUILLAUME CRNA
Provider Business Mailing Address
First Line : 451 CLARKSON AVE
Second Line : 3RD FLOOR
City : BROOKLYN
State : NY
Zip : 11203-2054
Country : US
Telephone Number : 718-245-4502
Fax Number :
Provider Business Practice Location Address
First Line : 451 CLARKSON AVE
Second Line : ANESTHESIA DEPARTMENT
City : BROOKLYN
State : NY
Zip : 11203-2054
Country : US
Telephone Number : 718-245-4502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 04/03/2014

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Directions to “ ELIZABETH GUILLAUME CRNA” Practice Location

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