Individual provider · NPI-1
Dr. Anne Felicia Ambrose, M.D.
Physical Medicine & Rehabilitation · Lake Grove, NY
NPI number1346218880
StatusActive
Last updated in NPPESDec 18, 2024
Details
- NPI
- 1346218880
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anne Felicia Ambrose
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 10, 2006
- Certification date
- Jul 6, 2020
- Last updated
- Dec 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 235243 | NY | Yes |
| 2081P0301X | Physical Medicine & Rehabilitation, Brain Injury Medicine | 235243 | NY |
Practice location
Neurology Associates Of Stony Brook4 Smith Haven Mall Suite 105
Lake Grove, NY 11755-2412
Phone 631-444-2599 · Fax 631-392-7213
Mailing address
10 Bell Circle RoadPort Jefferson, NY 11777
Phone 631-444-8118 · Fax 631-392-7213
Other practice locations
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