Provider Demographics
NPI:1225365950
Name:NIENSTEDT, ANNE VALERIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:VALERIE
Last Name:NIENSTEDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 KAREN COURT
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792
Mailing Address - Country:US
Mailing Address - Phone:631-953-7719
Mailing Address - Fax:631-953-7719
Practice Address - Street 1:67 KAREN COURT
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792
Practice Address - Country:US
Practice Address - Phone:631-953-7719
Practice Address - Fax:631-201-2045
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine