MEDICARE: ANNA PARDOE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101200000X	Drama Therapist	03227-01	NY

General Provider Information

NPI Number	:	1568395473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA PARDOE

Provider Business Mailing Address
First Line	:	143 W 85TH ST APT 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4430
Country	:	US
Telephone Number	:	646-413-9768
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 W 85TH ST APT 3
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4430
Country	:	US
Telephone Number	:	646-413-9768
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ ANNA PARDOE ” Practice Location

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