Provider Demographics
NPI:1114065562
Name:WIMPFHEIMER, ANN F (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:F
Last Name:WIMPFHEIMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 RIVERSIDE DR
Mailing Address - Street 2:4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5279
Mailing Address - Country:US
Mailing Address - Phone:212-666-5311
Mailing Address - Fax:
Practice Address - Street 1:865 W END AVE
Practice Address - Street 2:SUITE 1 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8401
Practice Address - Country:US
Practice Address - Phone:212-666-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014115-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7758801OtherAETNA
P1937348OtherOXFORD
NY7349715OtherGHI
11433876OtherCAQH
7758801OtherAETNA