Individual
ANNUPRIYA ITTEERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 HILLSIDE AVE, SUITE 206, NEW HYDE PARK, NY 11040-2521
(516) 974-6072
(516) 998-4113
Mailing address
54 OLD FIELD LANE, LAKE SUCCESS, NY 11020
(516) 974-6072
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
230227
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02533553
—
NY
01
—
02981H
GHI
—
Enumeration date
04/19/2006
Last updated
10/29/2012
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