Provider Demographics
NPI:1437662616
Name:GARN, ANNA (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GARN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:MCGILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-0103
Mailing Address - Country:US
Mailing Address - Phone:716-913-8287
Mailing Address - Fax:
Practice Address - Street 1:282 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2727
Practice Address - Country:US
Practice Address - Phone:607-729-9206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18620225X00000X
NY016293225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1437662616Medicaid