Active NPI
Annmarie Munn
- Specialist
- Tupper Lake, NY
National Provider Identifier
1174070486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1033054161
- Practice address
- 12 Mohawk St
Tupper Lake, NY 12986-1028 - Phone
- (518) 354-2456
- NPI assigned
- Sep 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1033054161 | NY | Primary |
Addresses
Primary practice location
12 Mohawk St
Tupper Lake, NY 12986-1028
Mailing address
12 Mohawk St
Tupper Lake, NY 12986-1028
Phone (518) 354-2456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033054161 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1174070486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 MOHAWK ST",
"city": "TUPPER LAKE",
"state": "NY",
"postal_code": "129861028",
"telephone_number": "518-354-2456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 MOHAWK ST",
"city": "TUPPER LAKE",
"state": "NY",
"postal_code": "129861028",
"telephone_number": "518-354-2456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNN",
"first_name": "ANNMARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-02",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1033054161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupper Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.