Provider Demographics
NPI:1588724280
Name:CINTRON ABENIS, ANNA (MS, PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:CINTRON ABENIS
Suffix:
Gender:F
Credentials:MS, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WAFER LANE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1229
Mailing Address - Country:US
Mailing Address - Phone:718-960-2994
Mailing Address - Fax:718-960-7042
Practice Address - Street 1:1225 GERARD AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-1839
Practice Address - Country:US
Practice Address - Phone:718-960-2994
Practice Address - Fax:718-960-7042
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012854-1103TC0700X
NY001428-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical