Healthcare Provider Details

I. General information

NPI: 1891233540
Provider Name (Legal Business Name): ANNE KUHL COMS, CTVI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 LAKE GEORGE AVE
TICONDEROGA NY
12883
US

IV. Provider business mailing address

70 LAKE GEORGE AVE
TICONDEROGA NY
12883
US

V. Phone/Fax

Practice location:
  • Phone: 518-585-7186
  • Fax:
Mailing address:
  • Phone: 518-585-7186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: