Individual
MR. BILL DAVID DIENSTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
600 IVY ST, SUITE 201, ELMIRA, NY 14905-1627
(607) 737-7780
(607) 737-7788
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006144
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006144
NY STATE LICENSE
NY
05
—
04297325
—
NY
Enumeration date
12/29/2010
Last updated
03/07/2023
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