Provider Demographics
NPI:1912157215
Name:CHACKO, ANEY THOMAS (ANP/GNP)
Entity type:Individual
Prefix:MRS
First Name:ANEY
Middle Name:THOMAS
Last Name:CHACKO
Suffix:
Gender:F
Credentials:ANP/GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N. MIDLAND AVE
Mailing Address - Street 2:NYACK HOSPITAL
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:845-348-2735
Mailing Address - Fax:845-348-2738
Practice Address - Street 1:160 N. MIDLAND AVE
Practice Address - Street 2:NYACK HOSPITAL
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960
Practice Address - Country:US
Practice Address - Phone:845-348-2735
Practice Address - Fax:845-348-2738
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304969-1363LA2100X
NYF340720-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology