Provider Demographics
NPI:1770814543
Name:GO, REBECCA DE GUZMAN (CRNA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DE GUZMAN
Last Name:GO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:BOX 124
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-2949
Mailing Address - Fax:212-746-8563
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX 124
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-2949
Practice Address - Fax:212-746-8563
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY552069163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse