Steffi Dittmar, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · Great Neck, NY

NPI 1710039201 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710039201
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
093911 (NY)
Practice address
865 Northern Blvd
Great Neck, NY 11021-5310
Phone
(516) 622-5202
Fax
(516) 622-5104
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
093911NYMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 093911 NY Yes

Addresses

Primary practice location

865 Northern Blvd
Great Neck, NY 11021-5310

Mailing address

865 Northern Blvd
Great Neck, NY 11021-5310
Phone (516) 622-5202

Other identifiers

IdentifierTypeStateIssuer
01143333MedicaidNY

Other providers in Great Neck, NY

All providers in Great Neck, NY · Obstetrics & Gynecology Physician in New York

Sources for this page

Verify at the official NPI Registry.