Provider Demographics
NPI:1093834871
Name:KING, ANNETTE MARIE (NP)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:KING
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1 GUSTAVE L. LEVY PLACE
Mailing Address - Street 2:BOX 1030
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-9454
Mailing Address - Fax:212-241-5107
Practice Address - Street 1:5 EAST 98TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-9454
Practice Address - Fax:212-241-5107
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2014-03-12
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Provider Licenses
StateLicense IDTaxonomies
NYF304123-1363LA2200X
NY304123-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health