Provider Demographics
NPI:1457643819
Name:KOEHNE DE GONZALEZ, ANNE KNOLL (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:KNOLL
Last Name:KOEHNE DE GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:633 3RD AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6943
Mailing Address - Country:US
Mailing Address - Phone:646-227-3813
Mailing Address - Fax:
Practice Address - Street 1:633 3RD AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6943
Practice Address - Country:US
Practice Address - Phone:646-227-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278347207ZP0102X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology