Individual provider · NPI-1

Anna Adam, MD

Internal Medicine · Stony Brook, NY

NPI number1306266705

StatusActive

Last updated in NPPESAug 6, 2020

Details

NPI: 1306266705
Entity type: Individual (NPI-1)
Name: Anna Adam
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: Apr 24, 2014
Certification date: Aug 6, 2020
Last updated: Aug 6, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	289943-1	NY	Yes
207R00000X	Internal Medicine	4301114100	MI
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

100 Nicolls Rd
Stony Brook, NY 11794-2153

Phone 631-444-8478

Mailing address

Po Box 1559
Stony Brook, NY 11790-0989

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