Provider Demographics
NPI:1760918668
Name:MC CREESH, ANN-MARIE
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:
Last Name:MC CREESH
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 1:160 MADISON AVE
Mailing Address - Street 2:APT 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5412
Mailing Address - Country:US
Mailing Address - Phone:917-444-0006
Mailing Address - Fax:
Practice Address - Street 1:160 MADISON AVE
Practice Address - Street 2:APT 5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5412
Practice Address - Country:US
Practice Address - Phone:917-444-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY728428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist