Provider Demographics
NPI:1316169899
Name:SKIANDOS, ANNA (DO)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SKIANDOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MADISON AVE
Mailing Address - Street 2:SUITE 10P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2820
Mailing Address - Country:US
Mailing Address - Phone:646-820-4090
Mailing Address - Fax:646-558-0377
Practice Address - Street 1:240 MADISON AVE
Practice Address - Street 2:SUITE 10P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2820
Practice Address - Country:US
Practice Address - Phone:646-820-4090
Practice Address - Fax:646-558-0377
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2401762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry