Provider Demographics
NPI:1699041194
Name:MCCOY, ANNA (6950179)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:6950179
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 AVENUE H APT 9F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3211
Mailing Address - Country:US
Mailing Address - Phone:347-425-9504
Mailing Address - Fax:
Practice Address - Street 1:70 TOMPKINS AVE
Practice Address - Street 2:P368@IS33
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5616
Practice Address - Country:US
Practice Address - Phone:718-388-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6950179163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse