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Individual

ANNA M STOCKHAUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5075 W SENECA TPKE, SYRACUSE, NY 13215-3216
(954) 377-2939
Mailing address
1643 NW 136TH AVE BLDG H, SUNRISE, FL 33323-3091
(954) 377-2939

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
322785-01
NY
207R00000X
Internal Medicine Physician
60601
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/11/2010
Last updated
07/17/2023
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