Basic Information
| Provider Information | |||||||||
| NPI: | 1700105533 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | AHN | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 ELKRIDGE LANDING RD | ||||||||
| Address2: | |||||||||
| City: | LINTHICUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210902917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434625010 | ||||||||
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| Practice Location | |||||||||
| Address1: | MEDICAL STAFF OFFICE T9 | ||||||||
| Address2: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442754 | ||||||||
| FaxNumber: | 6314446031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2010 | ||||||||
| LastUpdateDate: | 08/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 249976 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D75970 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.