Provider Demographics
NPI:1447945746
Name:OATIS, ANA MARIE
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIE
Last Name:OATIS
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 1:1312 HERKIMER ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3341
Mailing Address - Country:US
Mailing Address - Phone:646-361-9912
Mailing Address - Fax:
Practice Address - Street 1:1312 HERKIMER ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3341
Practice Address - Country:US
Practice Address - Phone:646-361-9912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier