Individual
DR. GEORGE DEITRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 W KINGSBRIDGE RD, JAMES J . PETERS VA MEDICAL CENTER, BRONX, NY 10468-3904
(718) 584-9000
Mailing address
17 KENWOOD RD, GARDEN CITY, NY 11530-3034
(516) 248-1420
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
188018-1
NY
208600000X
Surgery Physician
188018-1
NY
Other
Enumeration date
09/02/2006
Last updated
09/11/2025
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