Healthcare Provider Details

I. General information

NPI: 1124573738
Provider Name (Legal Business Name): ANNA HUFF PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MADISON AVE RM 305
NEW YORK NY
10016-0816
US

IV. Provider business mailing address

244 MADISON AVE STE 245
NEW YORK NY
10016-2817
US

V. Phone/Fax

Practice location:
  • Phone: 917-828-0525
  • Fax:
Mailing address:
  • Phone: 917-828-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005493
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: