1487661104 NPI number — DR. ANNE SARA NEGRIN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487661104 NPI number — DR. ANNE SARA NEGRIN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

NEGRIN

Provider First Name:

ANNE

Provider Middle Name:

SARA

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

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:

1487661104

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1333 NORTH AVE # 340A

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NEW ROCHELLE

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

10804-2120

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

917-584-5605

Provider Business Mailing Address Fax Number:

914-560-2128

Provider First Line Business Practice Location Address:

3020 WESTCHESTER AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

PURCHASE

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

10577-2510

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

917-584-5605

Provider Business Practice Location Address Fax Number:

914-560-2128

Provider Enumeration Date:

08/02/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207W00000X , with the licence number:  239838-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 02889054 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 3024543 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 8061728 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
• Identifier: 852B51 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 150615000073 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 780367 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
• Identifier: 8938938 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P100012128 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 15071938 . This is a "HUDSON HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 201516000046 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 37354976 . This is a "EMBLEM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".