Provider Demographics
NPI:1811074313
Name:FLEITES, MARIA DEL CARMEN (CRNA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:FLEITES
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 1:555 SHREWSBURY AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07754-0307
Mailing Address - Country:US
Mailing Address - Phone:732-450-6000
Mailing Address - Fax:
Practice Address - Street 1:1945 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-897-0200
Practice Address - Fax:732-897-0263
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR09043800367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043765Medicare ID - Type Unspecified