Provider Demographics
NPI:1427229913
Name:GORDON-WINT, ANNMARIE KETURA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:KETURA
Last Name:GORDON-WINT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3238 OLD YORKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2323
Mailing Address - Country:US
Mailing Address - Phone:914-962-0081
Mailing Address - Fax:914-962-0081
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-7023
Practice Address - Fax:718-324-1156
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF304461-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health