Individual provider Active NPI

Christina Renee Von Dietsch, LCSW

  • Basic Emergency Medical Technician
  • Patterson, NY
National Provider Identifier
1356565162
Registry record updated Aug 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
198554 Issued in NY
Practice address
215 Cornwall Meadows LN
Patterson, NY 12563-2652
Phone
(845) 878-3590
NPI assigned
Apr 12, 2007
Last updated
Aug 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 095521 NY
Basic Emergency Medical Technician 146N00000X 198554 NY Primary

Addresses

Primary practice location

215 Cornwall Meadows LN
Patterson, NY 12563-2652

Mailing address

215 Cornwall Meadows LN
Patterson, NY 12563-2652
Phone (845) 878-3590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
095521NYMDClinical Social Worker
198554NYMDGastroenterology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693008000000",
    "number": "1356565162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CORNWALL MEADOWS LN",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632652",
            "telephone_number": "845-878-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CORNWALL MEADOWS LN",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632652",
            "telephone_number": "845-878-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DIETSCH",
        "first_name": "CHRISTINA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-08-26",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095521",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "198554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.