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General NPI Number Information
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NPI Number | 1538151162
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Entity Type | Individual
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Provider Name | ANNE DENISE NEIRYNCK FNP, CDE
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Gender | Female
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 404 N CAYUGA ST
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City | ITHACA
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State | NY
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Zip | 14850-4219
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Country | US
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Telephone | 607-277-0969
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Fax | 607-277-3242
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Provider Business Mailing Address
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Address Line | 404 N CAYUGA ST
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City | ITHACA
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State | NY
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Zip | 14850-4219
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Country | US
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Telephone | 607-277-0969
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Fax | 607-277-3242
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | F332267
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F332267
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 2222-0372
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License Number State | NY
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