Most Relevant Information
Provider Data
| NPI Number: | 1003178054 |
| Provider Name: | ANISE ANTOINE MSED |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 223494 |
Most Important Dates
| Enumeration Date: | 06/14/2012 |
| Last Updated: | 09/21/2020 |
Provider Practice Location
107 E CARPENTER ST
VALLEY STREAM
NY
115804419
Practice Location Phone/Fax
| Phone: | 9178738776 |
| Fax: |
Provider Mailing Location
107 EAST CARPENTER ST.
VALLEY STREAM
NY
11580
Provider Mailing Phone/Fax
| Phone: | 9178738776 |
| Fax: |