Provider Demographics
NPI:1962484196
Name:MICK, ANN F (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:F
Last Name:MICK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:16 CENTER ST
Mailing Address - Street 2:STE 216
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3031
Mailing Address - Country:US
Mailing Address - Phone:413-584-3202
Mailing Address - Fax:413-586-7950
Practice Address - Street 1:16 CENTER ST
Practice Address - Street 2:STE 216
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3031
Practice Address - Country:US
Practice Address - Phone:413-584-3202
Practice Address - Fax:413-586-7950
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2010-07-21
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Provider Licenses
StateLicense IDTaxonomies
MA81941208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics