Basic Information
| Provider Information | |||||||||
| NPI: | 1487647558 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VIOLA | ||||||||
| FirstName: | MARCI | ||||||||
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| Credential: | C.R.N.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 ROUTE 59 | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109014927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453575775 | ||||||||
| FaxNumber: | 8453575777 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BAY AVE | ||||||||
| Address2: | ANESTHESIA OFFICE | ||||||||
| City: | MONTCLAIR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070424837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9734296219 | ||||||||
| FaxNumber: | 8455470740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 05/22/2014 | ||||||||
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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 | 25NJ00240200 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | 26NO05571800 | NJ | N | Nursing Service Providers | Registered Nurse |
No ID Information.