Provider Demographics
NPI:1972129807
Name:IACUONE, LIA C (CRNA)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:C
Last Name:IACUONE
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:19 BRADHURST AVE STE 3100N
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7000
Practice Address - Fax:914-493-7927
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY795145367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered