Provider Demographics
NPI:1811239551
Name:POMPONIO, ANNE MARIE (ATR, LCAT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:POMPONIO
Suffix:
Gender:F
Credentials:ATR, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 RIVERSIDE DR.
Mailing Address - Street 2:10D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:917-515-2540
Mailing Address - Fax:
Practice Address - Street 1:290 RIVERSIDE DR.
Practice Address - Street 2:10D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:917-515-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional