Healthcare Provider Details

I. General information

NPI: 1215298872
Provider Name (Legal Business Name): ANN MARIE DEFNET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 5TH AVE # 1B
NEW YORK NY
10128-0104
US

IV. Provider business mailing address

1060 5TH AVE # 1B
NEW YORK NY
10128-0104
US

V. Phone/Fax

Practice location:
  • Phone: 212-988-8269
  • Fax: 914-259-8313
Mailing address:
  • Phone: 212-988-8269
  • Fax: 914-259-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number304743
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: