Healthcare Provider Details

I. General information

NPI: 1295406957
Provider Name (Legal Business Name): FNU ANAMIKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FNU ANAMIKA

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 11/20/2024
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAST 77TH STREET
NEW YORK NY
10075
US

IV. Provider business mailing address

100 EAST 77TH STREET
NEW YORK NY
10075
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-2158
  • Fax:
Mailing address:
  • Phone: 315-464-5240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: