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General NPI Number Information
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NPI Number | 1407919673
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Entity Type | Individual
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Provider Name | FRANK DITTMAR D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 578 E SUNRISE HIGHWAY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6003
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Country | US
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Telephone | 631-893-7030
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Fax | 631-893-7066
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Provider Business Mailing Address
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Address Line | 578 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6003
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Country | US
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Telephone | 631-893-7030
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Fax | 631-893-7066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | N004074
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License Number State | NY
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