Provider Demographics
NPI:1275518292
Name:WHITMARSH, ANN BARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:BARD
Last Name:WHITMARSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 EAST 9 STREET
Mailing Address - Street 2:APT 2K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5415
Mailing Address - Country:US
Mailing Address - Phone:212-260-7286
Mailing Address - Fax:
Practice Address - Street 1:24 5TH AVE
Practice Address - Street 2:GROUND FLOOR SUITE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8858
Practice Address - Country:US
Practice Address - Phone:212-260-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0141521103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02046115Medicaid
NY02046115Medicaid