Provider Demographics
NPI:1841494200
Name:TUITT, IRIS V (CRNA)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:V
Last Name:TUITT
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 1:600 E 233RD STREET
Mailing Address - Street 2:MMC ANESTHESIOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466
Mailing Address - Country:US
Mailing Address - Phone:718-920-9510
Mailing Address - Fax:718-920-9582
Practice Address - Street 1:600 E 233RD STREET
Practice Address - Street 2:MMC ANESTHESIOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:718-920-9510
Practice Address - Fax:718-920-9582
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY376847163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR3C281Medicare ID - Type Unspecified