Provider Demographics
NPI:1326093329
Name:FLATTAU, ANNA (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:FLATTAU
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1005
Mailing Address - Country:US
Mailing Address - Phone:718-920-2007
Mailing Address - Fax:718-920-5416
Practice Address - Street 1:3544 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1005
Practice Address - Country:US
Practice Address - Phone:718-920-2007
Practice Address - Fax:718-920-5416
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY234337OtherLICENSE
NY234337OtherLICENSE