Healthcare Provider Details

I. General information

NPI: 1336383538
Provider Name (Legal Business Name): ANNE BARMETTLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3332 ROCHAMBEAU AVE FL 3
BRONX NY
10467-2836
US

IV. Provider business mailing address

2728 THOMSON AVE UNIT 514
LONG ISLAND CITY NY
11101-2931
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-2020
  • Fax:
Mailing address:
  • Phone: 978-886-7122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number274709
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: