Individual
LISA BETH DITCHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 E 94TH ST, NEW YORK, NY 10128-5604
(212) 423-3000
Mailing address
320 E 94TH ST, NEW YORK, NY 10128-5604
(212) 423-3000
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
315289
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
02/12/2024
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