MEDICARE: BITTERMAN STUART MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	160959	NY

General Provider Information

NPI Number	:	1548436850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BITTERMAN STUART MD

Provider Business Mailing Address
First Line	:	7734 113TH ST
Second Line	:	APT. B
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7133
Country	:	US
Telephone Number	:	718-544-6650
Fax Number	:	516-569-5893

Provider Business Practice Location Address
First Line	:	7734 113TH ST
Second Line	:	APT. B
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7133
Country	:	US
Telephone Number	:	718-544-6650
Fax Number	:	516-569-5893

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	STUART R BITTERMAN
Credential	:	M.D.
Telephone Number	:	718-544-6650

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	06/24/2008

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