Provider Demographics
NPI:1144469511
Name:NAVITSKI, ALANNA EDMONDS (MSED)
Entity type:Individual
Prefix:MS
First Name:ALANNA
Middle Name:EDMONDS
Last Name:NAVITSKI
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 1:1948 STATE ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:GHENT
Mailing Address - State:NY
Mailing Address - Zip Code:12075-2508
Mailing Address - Country:US
Mailing Address - Phone:917-309-2003
Mailing Address - Fax:
Practice Address - Street 1:1948 STATE ROUTE 66
Practice Address - Street 2:
Practice Address - City:GHENT
Practice Address - State:NY
Practice Address - Zip Code:12075-2508
Practice Address - Country:US
Practice Address - Phone:917-309-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160586222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist