Individual provider Active NPI

Cynthia M Polistena-Witman, D.C.

  • Chiropractor
  • Hyde Park, NY
National Provider Identifier
1619257979
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010695 Issued in NY
Practice address
16 Crumwold PL
Hyde Park, NY 12538-1107
Phone
(914) 466-9696
NPI assigned
Aug 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X010695 NY Primary

Addresses

Primary practice location

16 Crumwold PL
Hyde Park, NY 12538-1107

Mailing address

16 Crumwold PL
Hyde Park, NY 12538-1107
Phone (914) 466-9696

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
X010695NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1619257979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CRUMWOLD PL",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125381107",
            "telephone_number": "914-466-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CRUMWOLD PL",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125381107",
            "telephone_number": "914-466-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISTENA-WITMAN",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.