Provider Demographics
NPI:1245584903
Name:HAZEL, ANNAMARIE C (RN)
Entity Type:Individual
Prefix:MS
First Name:ANNAMARIE
Middle Name:C
Last Name:HAZEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 FRANKLIN AVE.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-746-2200
Mailing Address - Fax:516-746-6433
Practice Address - Street 1:501 FRANKLIN AVE.
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-746-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY618281-1163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management