Provider Demographics
NPI:1598737447
Name:FATONE, ANNE MARIE
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:FATONE
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 1:444 E 86TH ST
Mailing Address - Street 2:APT. 27E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6458
Mailing Address - Country:US
Mailing Address - Phone:212-249-2703
Mailing Address - Fax:
Practice Address - Street 1:1160 5TH AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6928
Practice Address - Country:US
Practice Address - Phone:212-427-9163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2878118OtherOXFORD PROVIDER
NYP2878118OtherOXFORD PROVIDER