Provider Demographics
NPI:1477766418
Name:CANACCI, ANASTASIA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:MARIE
Last Name:CANACCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11025 RCA CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4269
Mailing Address - Country:US
Mailing Address - Phone:336-387-2566
Mailing Address - Fax:844-751-9263
Practice Address - Street 1:706 GREEN VALLEY RD STE 104
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:336-387-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1732207ZC0500X, 207ZP0102X
NY247194-1207ZP0102X
NJ25MA08909600207ZP0102X
OH35.095262207ZP0102X
FLME111273207ZP0102X
NC2019-02064207ZP0102X
NC201902064207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology