Provider Demographics
NPI:1326006313
Name:ANN M NEGRI MD
Entity Type:Organization
Organization Name:ANN M NEGRI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NEGRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-695-8819
Mailing Address - Street 1:10240 N 31ST AVE
Mailing Address - Street 2:SUIT 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9558
Mailing Address - Country:US
Mailing Address - Phone:602-997-9006
Mailing Address - Fax:602-997-4585
Practice Address - Street 1:23233 N PIMA RD
Practice Address - Street 2:113-351
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-8388
Practice Address - Country:US
Practice Address - Phone:480-513-7311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0138291041C0700X
PACW0134651041C0700X
PACW0121751041C0700X
PAMD027706E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033115795OtherINDIVIDUAL NPI
NC9601683OtherNORTH CAROLINA LICENSE
PA631100OtherHIGHMARK PROVIDER NUMBER
PA0884882Medicaid
AZ32836OtherARIZONA LICENSE
PANE184493Medicare ID - Type Unspecified
AZ32836OtherARIZONA LICENSE