Provider Demographics
NPI:1174698872
Name:ANNA S KRAYN PHD PC
Entity type:Organization
Organization Name:ANNA S KRAYN PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRAYN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-986-9872
Mailing Address - Street 1:PO BOX 1665
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07653-1665
Mailing Address - Country:US
Mailing Address - Phone:201-986-9872
Mailing Address - Fax:201-986-0397
Practice Address - Street 1:3043 OCEAN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3497
Practice Address - Country:US
Practice Address - Phone:718-934-5907
Practice Address - Fax:201-986-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0488941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN3W181OtherMEDICARE ID