Healthcare Provider Details

I. General information

NPI: 1013458165
Provider Name (Legal Business Name): ANNA GINZBURG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W 239TH ST J.W. BEATMAN
BRONX NY
10463-1205
US

IV. Provider business mailing address

521 W 239TH ST J.W. BEATMAN
BRONX NY
10463-1205
US

V. Phone/Fax

Practice location:
  • Phone: 718-601-2280
  • Fax:
Mailing address:
  • Phone: 718-601-2280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number099101-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: