Healthcare Provider Details

I. General information

NPI: 1841433620
Provider Name (Legal Business Name): ANNE DAUGHERTY REUTER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 04/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 95TH ST AREA I
NEW YORK NY
10128-4077
US

IV. Provider business mailing address

1212 6TH AVE ROOM 803
NEW YORK NY
10036-1602
US

V. Phone/Fax

Practice location:
  • Phone: 212-996-8000
  • Fax: 212-423-3127
Mailing address:
  • Phone: 917-510-2854
  • Fax: 917-510-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV007373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: