Provider Demographics
NPI:1164046868
Name:HOPPER, ANNA HINGSTON (RRA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:HINGSTON
Last Name:HOPPER
Suffix:
Gender:F
Credentials:RRA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:HINGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2482
Mailing Address - Country:US
Mailing Address - Phone:518-782-3110
Mailing Address - Fax:
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000242243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant