Provider Demographics
NPI:1952960643
Name:MURASKI, BETHANIE KALA (FNP)
Entity Type:Individual
Prefix:
First Name:BETHANIE
Middle Name:KALA
Last Name:MURASKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 N MAIN ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1673
Mailing Address - Country:US
Mailing Address - Phone:315-458-8700
Mailing Address - Fax:315-701-1075
Practice Address - Street 1:792 N MAIN ST STE 200A
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1673
Practice Address - Country:US
Practice Address - Phone:315-458-8700
Practice Address - Fax:315-701-1075
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily