MEDICARE: MS. ANNE BECKERT KUCHINS GNP

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	363LG0600X	Gerontology Nurse Practitioner	F340039	NY

General Provider Information

NPI Number	:	1639152192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE BECKERT KUCHINS GNP

Provider Business Mailing Address
First Line	:	72 GARFIELD ST
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-2405
Country	:	US
Telephone Number	:	718-888-6799
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 20 ASTORIA BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11370
Country	:	US
Telephone Number	:	917-843-3246
Fax Number	:

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

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	07/09/2007

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