Basic Information
Provider Information
NPI: 1083795967
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMLIN
FirstName: ANN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: REED/ROZANSKI
OtherFirstName: ANN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 1020 MARY ST
Address2:  
City: UTICA
State: NY
PostalCode: 135011930
CountryCode: US
TelephoneNumber: 3157246907
FaxNumber: 3157330791
Practice Location
Address1: 1427 GENESEE ST
Address2:  
City: UTICA
State: NY
PostalCode: 135014343
CountryCode: US
TelephoneNumber: 3157381428
FaxNumber: 3157381461
Other Information
ProviderEnumerationDate: 10/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X040812NYY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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