Provider Demographics
NPI:1629551205
Name:JAUREGUI, ANNE W
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:W
Last Name:JAUREGUI
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 1:39 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560-1628
Mailing Address - Country:US
Mailing Address - Phone:516-754-1090
Mailing Address - Fax:
Practice Address - Street 1:39 WOOD LN
Practice Address - Street 2:
Practice Address - City:LOCUST VALLEY
Practice Address - State:NY
Practice Address - Zip Code:11560-1628
Practice Address - Country:US
Practice Address - Phone:516-754-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No252Y00000XAgenciesEarly Intervention Provider Agency