Provider Demographics
NPI:1306832878
Name:FILS-AIME, ANNIE MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MELISSA
Last Name:FILS-AIME
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 1:1624 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1104
Mailing Address - Country:US
Mailing Address - Phone:718-376-2220
Mailing Address - Fax:718-376-3226
Practice Address - Street 1:1624 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1104
Practice Address - Country:US
Practice Address - Phone:718-376-2220
Practice Address - Fax:718-376-3226
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210367207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG86938Medicare UPIN
NY51G351Medicare ID - Type Unspecified