Provider Demographics
NPI:1154334308
Name:CHARVAT, ANNE MARIE
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:CHARVAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SIGNAL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9559
Mailing Address - Country:US
Mailing Address - Phone:716-686-9066
Mailing Address - Fax:
Practice Address - Street 1:177 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1826
Practice Address - Country:US
Practice Address - Phone:716-686-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist