Provider Demographics
NPI:1841345147
Name:PAW, JAMES (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:PAW
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1807
Mailing Address - Country:US
Mailing Address - Phone:718-829-0570
Mailing Address - Fax:718-829-0570
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA 3RD FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:171-851-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY461231367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered