Provider Demographics
NPI:1609805068
Name:BEDDOE, ANN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:BEDDOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7215
Mailing Address - Country:US
Mailing Address - Phone:212-888-8439
Mailing Address - Fax:212-319-1140
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7215
Practice Address - Country:US
Practice Address - Phone:212-888-8439
Practice Address - Fax:212-319-1140
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140612207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE36432Medicare UPIN