Provider Demographics
NPI:1902140023
Name:CHETNIK, ANNA MARGARET (PT, DPT, DIP MDT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARGARET
Last Name:CHETNIK
Suffix:
Gender:F
Credentials:PT, DPT, DIP MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 EAST DR
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12443-5803
Mailing Address - Country:US
Mailing Address - Phone:917-334-0954
Mailing Address - Fax:
Practice Address - Street 1:1300 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1501
Practice Address - Country:US
Practice Address - Phone:845-481-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400082627Medicare PIN