Provider Demographics
NPI:1598016933
Name:SONGCO, ANNE LLAMOSO (NP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:LLAMOSO
Last Name:SONGCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 BAY PARKWAY
Mailing Address - Street 2:SUITE 901
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204
Mailing Address - Country:US
Mailing Address - Phone:718-238-2100
Mailing Address - Fax:718-534-5606
Practice Address - Street 1:6010 BAY PARKWAY
Practice Address - Street 2:SUITE 901
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204
Practice Address - Country:US
Practice Address - Phone:718-238-2100
Practice Address - Fax:718-534-5606
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2014-08-06
Deactivation Date:2013-03-13
Deactivation Code:
Reactivation Date:2013-09-04
Provider Licenses
StateLicense IDTaxonomies
NYF340843-1363LG0600X
NYF306043-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health