=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194805010
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNA I HOLMGREN MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2006
-----------------------------------------------------
Last Update Date | 04/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 156 5TH AVE STE 822
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-7765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-546-0999
-----------------------------------------------------
Fax | 917-277-8403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 156 5TH AVE STE 822
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-7765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-546-0999
-----------------------------------------------------
Fax | 917-277-8403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0015X
-----------------------------------------------------
Taxonomy Name | Psychosomatic Medicine Physician
-----------------------------------------------------
License Number | 223397
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 223397
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------