Provider Demographics
NPI:1962286930
Name:POPPER, ANNA KIM (MSED)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KIM
Last Name:POPPER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JENNINGS TOWN LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HALL
Mailing Address - State:NY
Mailing Address - Zip Code:10916-3429
Mailing Address - Country:US
Mailing Address - Phone:845-220-6520
Mailing Address - Fax:
Practice Address - Street 1:384 CRYSTAL RUN RD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4072
Practice Address - Country:US
Practice Address - Phone:845-728-1623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist