1023486578 NPI number — MS. ANAMARIA PONTES MS, RD, CDN

Table of content: MS. ANAMARIA PONTES MS, RD, CDN (NPI 1023486578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023486578 NPI number — MS. ANAMARIA PONTES MS, RD, CDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PONTES
Provider First Name:
ANAMARIA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, CDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023486578
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
169 E 101ST ST
Provider Second Line Business Mailing Address:
SUITE NUMBER 7
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10029-6128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-215-5439
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
248 E 73RD ST
Provider Second Line Business Practice Location Address:
SUITE NUMER 4
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021-4303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-744-9949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  008073-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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