Provider Demographics
NPI:1487614814
Name:KAZANSKAYA, ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:KAZANSKAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:20 BRONXVILLE GLEN DR
Mailing Address - Street 2:APT 3-5
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6872
Mailing Address - Country:US
Mailing Address - Phone:914-255-4483
Mailing Address - Fax:914-637-1134
Practice Address - Street 1:16 GUION PL
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5503
Practice Address - Country:US
Practice Address - Phone:914-637-1646
Practice Address - Fax:914-637-1134
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT040616207R00000X
NY247274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001406166Medicaid
CT110008679Medicare ID - Type Unspecified
CTH70658Medicare UPIN