Healthcare Provider Details

I. General information

NPI: 1275549966
Provider Name (Legal Business Name): ANNE M AGUIRRE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5989 BIG TREE RD SUITE A
LAKEVILLE NY
14480-9719
US

IV. Provider business mailing address

PO BOX 91
WATERTOWN NY
13601-0091
US

V. Phone/Fax

Practice location:
  • Phone: 585-346-4462
  • Fax: 585-346-4463
Mailing address:
  • Phone: 315-782-4207
  • Fax: 315-782-8699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF333226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: