# ST. ANNE'S MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861923948
- **Authorized official:** DR. JEANINE E. GRAVES OD (ADMINISTRATOR)
- **Authorized official phone:** (201) 310-6947

## Contact information

- **Practice address:** 64 NAGLE AVE, NEW YORK, NY 10040-1406
- **Practice address phone:** (201) 310-6947
- **Practice address fax:** (201) 796-2205
- **Mailing address:** 10 AUSTIN PL, CLIFTON, NJ 07014-1901
- **Mailing address phone:** (201) 310-6947
- **Mailing address fax:** (201) 796-2205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2017
- **Last updated:** 03/21/2017