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
| License | State | Type | Specialty |
|---|---|---|---|
| 093911 | NY | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01143333 | Medicaid | NY |
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All providers in Great Neck, NY · Obstetrics & Gynecology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.