Provider Demographics
NPI:1366179004
Name:COENE, ANNA KATHRYN
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHRYN
Last Name:COENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16490 COUNTY ROUTE 181
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:13624-3196
Mailing Address - Country:US
Mailing Address - Phone:315-778-4954
Mailing Address - Fax:
Practice Address - Street 1:20104 ARSENAL STREET RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5555
Practice Address - Country:US
Practice Address - Phone:315-779-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist