Provider Demographics
NPI:1083653570
Name:CROSS RIVER ANESTHESIOLOGIST SERVICES, PC-CRNA
Entity Type:Organization
Organization Name:CROSS RIVER ANESTHESIOLOGIST SERVICES, PC-CRNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-666-8866
Mailing Address - Street 1:43 KENSICO DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1009
Mailing Address - Country:US
Mailing Address - Phone:914-666-8866
Mailing Address - Fax:914-666-6777
Practice Address - Street 1:6511 SPRING BROOK AVE
Practice Address - Street 2:NORTHERN DUTCHESS HOSPITAL
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3709
Practice Address - Country:US
Practice Address - Phone:845-871-3368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW80301Medicare PIN
NYW80303Medicare PIN
NYW80302Medicare PIN
NYW80661Medicare PIN