Provider Demographics
NPI:1396867990
Name:TAUB, ANN S (CPNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:TAUB
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN HARBOUR
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-868-6100
Mailing Address - Fax:516-546-8621
Practice Address - Street 1:860 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN HARBOUR
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-868-6100
Practice Address - Fax:516-546-8621
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3809401363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner