Individual
ANN-MARIE CIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19432 111TH AVE, SAINT ALBANS, NY 11412-2014
(646) 691-6477
Mailing address
19432 111TH AVE, SAINT ALBANS, NY 11412-2014
(646) 691-6477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F343206-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F343206-01
NY
Other
Enumeration date
10/01/2018
Last updated
10/21/2022
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