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General NPI Number Information
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NPI Number | 1366678732
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Entity Type | Individual
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Provider Name | ANNETTE PEOPLES RPA-C
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Gender | Female
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Dates
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Enumeration Date | 05/30/2009
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 450 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1118
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Country | US
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Telephone | 516-734-8730
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Fax |
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Provider Business Mailing Address
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Address Line | 642 E 59TH ST
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City | BROOKLYN
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State | NY
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Zip | 11234-1302
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Country | US
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Telephone | 718-209-0102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 005624
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License Number State | NY
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