Healthcare Provider Details

I. General information

NPI: 1740298611
Provider Name (Legal Business Name): DIANN G ANTHONY DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 ROOSEVELT AVE STE 108
VALLEY STREAM NY
11581-1106
US

IV. Provider business mailing address

30 DEVON ROAD
HEMPSTEAD NY
11550
US

V. Phone/Fax

Practice location:
  • Phone: 516-284-6307
  • Fax: 516-252-3012
Mailing address:
  • Phone: 718-527-0366
  • Fax: 718-527-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: