Provider Demographics
NPI:1194805010
Name:HOLMGREN, ANNA I (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:I
Last Name:HOLMGREN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 5TH AVE STE 822
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7765
Mailing Address - Country:US
Mailing Address - Phone:212-546-0999
Mailing Address - Fax:917-277-8403
Practice Address - Street 1:156 5TH AVE STE 822
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7765
Practice Address - Country:US
Practice Address - Phone:212-546-0999
Practice Address - Fax:917-277-8403
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2233972084P0015X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY223397OtherNEW YORK STATE
NY00246075Medicaid
NY00246075Medicaid