Provider Demographics
NPI:1669535746
Name:BYRNES, ANNE E (BC-HIS)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:E
Last Name:BYRNES
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1369
Mailing Address - Country:US
Mailing Address - Phone:860-224-1617
Mailing Address - Fax:860-224-1619
Practice Address - Street 1:747 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-1369
Practice Address - Country:US
Practice Address - Phone:860-224-1617
Practice Address - Fax:860-224-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT224237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004242640Medicaid
CT207000770Medicaid