MEDICARE: DR. ANNE-MARIE JOSE AUDET MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	81809	MA

General Provider Information

NPI Number	:	1538142104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE-MARIE JOSE AUDET MD

Provider Business Mailing Address
First Line	:	140 W 86TH ST
Second Line	:	APT 9A
City	:	NEW YORK
State	:	NY
Zip	:	10024-4034
Country	:	US
Telephone Number	:	212-877-0133
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E 75TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-2608
Country	:	US
Telephone Number	:	212-606-3856
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/08/2007

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