Provider Demographics
NPI:1467798470
Name:PISANO, ANN (MSEDU)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:PISANO
Suffix:
Gender:F
Credentials:MSEDU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 DEWITT MILLS RD
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12443-6213
Mailing Address - Country:US
Mailing Address - Phone:845-532-6999
Mailing Address - Fax:
Practice Address - Street 1:82 DEWITT MILLS RD
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12443-6213
Practice Address - Country:US
Practice Address - Phone:845-532-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor