Provider Demographics
NPI:1487348579
Name:ANYANE, WILLIAM ISAAC
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ISAAC
Last Name:ANYANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4472
Mailing Address - Country:US
Mailing Address - Phone:860-706-6729
Mailing Address - Fax:860-645-0540
Practice Address - Street 1:357 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4472
Practice Address - Country:US
Practice Address - Phone:860-706-6729
Practice Address - Fax:860-645-0540
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0002098376J00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker