Provider Demographics
NPI:1144874009
Name:IZAGUIRRE, CARLOTA OTILIA (DNP, CRNA)
Entity type:Individual
Prefix:DR
First Name:CARLOTA
Middle Name:OTILIA
Last Name:IZAGUIRRE
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:550 PROSPECT PL APT 304
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-6938
Mailing Address - Country:US
Mailing Address - Phone:718-208-8159
Mailing Address - Fax:
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-208-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02533367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered