Provider Demographics
NPI:1578069555
Name:GARNSEY, ANISSA LOUISE
Entity Type:Individual
Prefix:
First Name:ANISSA
Middle Name:LOUISE
Last Name:GARNSEY
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 1:82 PETTIS RD
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1925
Mailing Address - Country:US
Mailing Address - Phone:603-682-3745
Mailing Address - Fax:
Practice Address - Street 1:158 HARMON DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:VT
Practice Address - Zip Code:05663-1000
Practice Address - Country:US
Practice Address - Phone:603-682-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer