Provider Demographics
NPI:1043870389
Name:VANHEMMEN, ANNEMARIE
Entity type:Individual
Prefix:MS
First Name:ANNEMARIE
Middle Name:
Last Name:VANHEMMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 GREEN GROVE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-2114
Mailing Address - Country:US
Mailing Address - Phone:631-829-4959
Mailing Address - Fax:
Practice Address - Street 1:44 GREEN GROVE AVE APT B
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-2114
Practice Address - Country:US
Practice Address - Phone:631-829-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer