Healthcare Provider Details

I. General information

NPI: 1427993674
Provider Name (Legal Business Name): DINARA LITMANOVICH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 ALEX CIR
STATEN ISLAND NY
10305-4765
US

IV. Provider business mailing address

143 ALEX CIR
STATEN ISLAND NY
10305-4765
US

V. Phone/Fax

Practice location:
  • Phone: 917-538-4347
  • Fax: 917-538-4347
Mailing address:
  • Phone: 917-538-4347
  • Fax: 917-538-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360050-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: