Provider Demographics
NPI:1275724148
Name:O'LOONEY, ANNA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA MARIE
Middle Name:
Last Name:O'LOONEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANNA MARIE
Other - Middle Name:
Other - Last Name:O'LOONEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:16 CONKLIN DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-3667
Mailing Address - Country:US
Mailing Address - Phone:845-499-0075
Mailing Address - Fax:
Practice Address - Street 1:54 S LIBERTY DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980
Practice Address - Country:US
Practice Address - Phone:845-596-4608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00643400111N00000X, 246ZE0600X
NY011107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60062000Medicaid