Provider Demographics
NPI:1528216488
Name:CROSS, ANN-MARIE (CASAC T)
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:CASAC T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3626
Mailing Address - Country:US
Mailing Address - Phone:212-369-5100
Mailing Address - Fax:
Practice Address - Street 1:448 E 119TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3626
Practice Address - Country:US
Practice Address - Phone:212-369-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)