Individual
ANANNYA SHAJI JOHNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-4600
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-4600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
26NJ15087300
NJ
363LF0000X
Family Nurse Practitioner
Primary
350053
NY
Other
Enumeration date
10/06/2022
Last updated
09/09/2025
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