Provider Demographics
NPI:1588645816
Name:AMZEL, ANOUK (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANOUK
Middle Name:
Last Name:AMZEL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 PENNSYLVANIA AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20004
Mailing Address - Country:US
Mailing Address - Phone:703-473-7160
Mailing Address - Fax:
Practice Address - Street 1:4924 CAMPBELL BLVD STE 125
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5921
Practice Address - Country:US
Practice Address - Phone:443-461-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205743208000000X
MDD0069319208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02102656Medicaid
NY02102656Medicaid
NYH80451Medicare UPIN