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Individual

MS. AMY C. DITTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
450 WAVERLY AVE, STE 11, PATCHOGUE, NY 11772-1555
(917) 385-9195
Mailing address
282 AUBORN AVE, SHIRLEY, NY 11967-1734
(917) 385-9195

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
639551
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402005
NY

Other

Enumeration date
05/20/2010
Last updated
03/25/2020
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