Provider Demographics
NPI:1992958748
Name:CRITICOS, ANNE KATHERINE (PHD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KATHERINE
Last Name:CRITICOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 TUCKAHOE RD
Mailing Address - Street 2:NO. 15
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5248
Mailing Address - Country:US
Mailing Address - Phone:914-779-5290
Mailing Address - Fax:
Practice Address - Street 1:317 NORTH STREET
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-597-4073
Practice Address - Fax:914-597-4012
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006583103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist