Provider Demographics
NPI:1538692017
Name:KAHN, ANNE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:KAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113-115 UNIVERSITY PLACE
Mailing Address - Street 2:FLOOR 9
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:917-648-0626
Mailing Address - Fax:
Practice Address - Street 1:113-115 UNIVERSITY PLACE
Practice Address - Street 2:FLOOR 9
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:917-648-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015158-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist