Basic Information
| Provider Information | |||||||||
| NPI: | 1093712317 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WALSH | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 550, 2 CATHARINE STREET | ||||||||
| Address2: | EAST MANHATTAN ANESTHESIA PARTNERS, LLC | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126020550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668688415 | ||||||||
| FaxNumber: | 8457902675 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 E. 14TH STREET | ||||||||
| Address2: | NY EYE & EAR INFIRMARY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129794464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2005 | ||||||||
| LastUpdateDate: | 08/07/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 256196 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 256196-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.