Healthcare Provider Details

I. General information

NPI: 1831926963
Provider Name (Legal Business Name): ANNA-MARIE ABREU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 BLUE POINT AVE
BLUE POINT NY
11715-1224
US

IV. Provider business mailing address

80 SHIRLEY LN
MEDFORD NY
11763-1321
US

V. Phone/Fax

Practice location:
  • Phone: 866-794-1644
  • Fax:
Mailing address:
  • Phone: 631-300-9824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number876401-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: