Healthcare Provider Details

I. General information

NPI: 1487694527
Provider Name (Legal Business Name): THERESA MARIE PITTMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 JEFFERSON HTS
CATSKILL NY
12414-1239
US

IV. Provider business mailing address

16 ASPRION RD
GLENMONT NY
12077-3300
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-9380
  • Fax:
Mailing address:
  • Phone: 518-225-9929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304380
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: