Provider Demographics
NPI:1437264371
Name:TRUPPI, ANN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:TRUPPI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 DELAWARE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1436
Mailing Address - Country:US
Mailing Address - Phone:518-427-5004
Mailing Address - Fax:518-432-5750
Practice Address - Street 1:274 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1436
Practice Address - Country:US
Practice Address - Phone:518-427-5004
Practice Address - Fax:518-432-5750
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015222103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02286762Medicaid
NY02286762Medicaid