Provider Demographics
NPI:1164788550
Name:LICHTENSTEIN, ANN HALEY (DO)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:HALEY
Last Name:LICHTENSTEIN
Suffix:
Gender:F
Credentials:DO
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Other - First Name:
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Mailing Address - Street 1:1355 PICCARD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4317
Mailing Address - Country:US
Mailing Address - Phone:301-921-4400
Mailing Address - Fax:301-921-4433
Practice Address - Street 1:1355 PICCARD DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4317
Practice Address - Country:US
Practice Address - Phone:301-921-4400
Practice Address - Fax:301-921-4433
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHE33002081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine