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General NPI Number Information
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NPI Number | 1720562853
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Entity Type | Individual
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Provider Name | LEANN DITTRICH FNP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 157 TOMAHAWK ST
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-6314
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Country | US
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Telephone | 914-248-0500
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Fax | 914-444-4248
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Provider Business Mailing Address
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Address Line | 157 TOMAHAWK ST
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-6314
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Country | US
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Telephone | 914-248-0500
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Fax | 914-444-4248
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 343620
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License Number State | NY
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