Provider Demographics
NPI:1417085655
Name:PRIMUS-ARMSTRONG, JOYLIN P (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JOYLIN
Middle Name:P
Last Name:PRIMUS-ARMSTRONG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TRAILSIDE PL
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1312
Mailing Address - Country:US
Mailing Address - Phone:845-638-0227
Mailing Address - Fax:
Practice Address - Street 1:100 ROUTE 59
Practice Address - Street 2:SUITE 105
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4927
Practice Address - Country:US
Practice Address - Phone:845-357-5770
Practice Address - Fax:845-357-8263
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY392003367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR5A0220Medicare ID - Type Unspecified