Provider Demographics
NPI:1003069709
Name:PEPITONE, ANNAMARIA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNAMARIA
Middle Name:
Last Name:PEPITONE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MANHASSET TRL
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-2281
Mailing Address - Country:US
Mailing Address - Phone:631-745-7334
Mailing Address - Fax:
Practice Address - Street 1:2 CORACI BLVD STE 10
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-4833
Practice Address - Country:US
Practice Address - Phone:631-281-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335179-1363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003069709OtherANTHEM