Provider Demographics
NPI:1386374064
Name:IFRAIMOV, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:IFRAIMOV
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANYA
Other - Middle Name:L
Other - Last Name:MARGULIS-BATSHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:68 VIRGINIA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1916
Mailing Address - Country:US
Mailing Address - Phone:917-921-9911
Mailing Address - Fax:
Practice Address - Street 1:68 VIRGINIA AVE FL 2
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1916
Practice Address - Country:US
Practice Address - Phone:917-921-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011373-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty