Provider Demographics
NPI:1215911078
Name:SURACE, CATHY L (CRNA)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:L
Last Name:SURACE
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 1:43 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 1:50 E 69TH ST
Practice Address - Street 2:CENTER FOR SPECIALTY CARE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5002
Practice Address - Country:US
Practice Address - Phone:212-249-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY498496367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00277856OtherRAIL ROAD MEDICARE
NYP00277856OtherRAIL ROAD MEDICARE