Provider Demographics
NPI:1598049405
Name:XAVIER, ANITHA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANITHA
Middle Name:
Last Name:XAVIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 HUGUENOT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7760
Mailing Address - Country:US
Mailing Address - Phone:914-607-5820
Mailing Address - Fax:914-687-5821
Practice Address - Street 1:171 HUGUENOT ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7760
Practice Address - Country:US
Practice Address - Phone:914-607-5820
Practice Address - Fax:914-687-5821
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336701-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03413967Medicaid