Provider Demographics
NPI:1891598629
Name:GARCON, ANNE T
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:T
Last Name:GARCON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17731 TROUTVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2711
Mailing Address - Country:US
Mailing Address - Phone:646-249-4492
Mailing Address - Fax:
Practice Address - Street 1:17731 TROUTVILLE RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2711
Practice Address - Country:US
Practice Address - Phone:646-249-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY818449252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency