MEDICARE: ANNA KEIKO EMY

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1669119756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KEIKO EMY

Provider Business Mailing Address
First Line	:	404 E 91ST ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-6807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 SAINT JOHNS PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3405
Country	:	US
Telephone Number	:	347-821-2094
Fax Number	:

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

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	05/19/2022

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Directions to “ ANNA KEIKO EMY ” Practice Location

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