Basic Information
| Provider Information | |||||||||
| NPI: | 1952379323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRIBIS | ||||||||
| FirstName: | ANNEKE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5344 SACANDAGA RD | ||||||||
| Address2: | P.O. BOX 190 | ||||||||
| City: | GALWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120742424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188826955 | ||||||||
| FaxNumber: | 5188825575 | ||||||||
| Practice Location | |||||||||
| Address1: | 5344 SACANDAGA RD | ||||||||
| Address2: | |||||||||
| City: | GALWAY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120742424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188826955 | ||||||||
| FaxNumber: | 5188825575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 06/10/2014 | ||||||||
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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 | 207Q00000X | 236225 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.