Provider Demographics
NPI:1174289425
Name:CARNAHAN, ANNA KATHLEEN (PTA)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:KATHLEEN
Last Name:CARNAHAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3120
Mailing Address - Country:US
Mailing Address - Phone:216-272-8326
Mailing Address - Fax:
Practice Address - Street 1:FASNY FIREMEN'S HOME
Practice Address - Street 2:125 HARRY HOWARD BLVD
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1253
Practice Address - Country:US
Practice Address - Phone:216-272-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012969225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant