Individual
DR. KISRA ANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461-1138
(718) 918-3060
(718) 918-4469
Mailing address
25 ST ANTHONY PL, MAHOPAC, NY 10541-2763
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207404
NY
207RN0300X
Nephrology Physician
Primary
207404
NY
207RR0500X
Rheumatology Physician
207404
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02210451
—
NY
Enumeration date
03/06/2007
Last updated
05/07/2015
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