Provider Demographics
NPI:1861061095
Name:WANAT, KARI-ANN
Entity type:Individual
Prefix:
First Name:KARI-ANN
Middle Name:
Last Name:WANAT
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 1:201 W 120TH ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6463
Mailing Address - Country:US
Mailing Address - Phone:203-376-6220
Mailing Address - Fax:
Practice Address - Street 1:201 W 120TH ST APT 2E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6463
Practice Address - Country:US
Practice Address - Phone:203-376-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist