Provider Demographics
NPI:1699935502
Name:ANKRAH, CARL
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:ANKRAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 PELHAM RD APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1435
Mailing Address - Country:US
Mailing Address - Phone:914-355-4084
Mailing Address - Fax:914-355-4084
Practice Address - Street 1:275 ROUTE 304 STE 200
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954
Practice Address - Country:US
Practice Address - Phone:845-507-0441
Practice Address - Fax:845-507-0501
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY572749-1163W00000X
NYF4013441363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse