Provider Demographics
NPI:1417848060
Name:DEFREITAS, ANN M
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:DEFREITAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 AUSTIN ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3024
Mailing Address - Country:US
Mailing Address - Phone:917-862-2452
Mailing Address - Fax:
Practice Address - Street 1:12116 POWELLS COVE BLVD APT B
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1297
Practice Address - Country:US
Practice Address - Phone:646-741-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist