# INGEBORG DZIEDZIC, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356618193
- **Authorized official:** MRS. NORA DEMPSEY (BILLING REPRESENTATIVE)
- **Authorized official phone:** (914) 769-0400

## Contact information

- **Practice address:** 320 MANVILLE RD, PLEASANTVILLE, NY 10570-2146
- **Practice address phone:** (914) 769-0400
- **Practice address fax:** (914) 769-1405
- **Mailing address:** 320 MANVILLE RD, PLEASANTVILLE, NY 10570-2146
- **Mailing address phone:** (914) 769-0400
- **Mailing address fax:** (914) 769-1405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 153848-1 | NY | Yes |

## Other

- **Enumeration date:** 11/22/2011
- **Last updated:** 12/20/2011