Provider Demographics
NPI:1811198872
Name:JOSEPH, ANNEY KUNTHARA (OD)
Entity Type:Individual
Prefix:
First Name:ANNEY
Middle Name:KUNTHARA
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANNEY
Other - Middle Name:
Other - Last Name:KUNTHARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2700 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-607-5730
Mailing Address - Fax:914-457-1195
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8999
Practice Address - Fax:914-848-8998
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003092152W00000X
TX7161T152W00000X
NY008896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB127576Medicare PIN