Provider Demographics
NPI:1902970247
Name:HAMIK, ANNE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:HAMIK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:631-638-4170
Practice Address - Street 1:HSC T16 080
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8167
Practice Address - Country:US
Practice Address - Phone:631-444-1060
Practice Address - Fax:631-444-1054
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088923207R00000X, 207RC0000X
NY284923207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH421800OtherWELLCARE
OH2703668Medicaid
OH745090OtherBUCKEYE
OHP00374195OtherRAILROAD MEDICARE
OH000000539502OtherANTHEM
OH000000224467OtherUNISON
OH7377942OtherAETNA
OHP00459808OtherRAILROAD MEDICARE
OH7377942OtherAETNA
OHP00374195OtherRAILROAD MEDICARE
HA4196532Medicare PIN