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NPI Code Detail

MEDICARE: JOHN LITT

MEDICARE: JOHN LITT
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
1103TC0700XClinical Psychologist014814-1NY

General Provider Information

NPI Number : 1255702049
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN LITT
Provider Business Mailing Address
First Line : 278 N WASHINGTON ST APT 2
Second Line :
City : SLEEPY HOLLOW
State : NY
Zip : 10591-2329
Country : US
Telephone Number : 718-742-6067
Fax Number :
Provider Business Practice Location Address
First Line : 595 GERARD AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5239
Country : US
Telephone Number : 718-742-6067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2015
Last Update Date : 10/19/2015

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