Individual
BETSY DANIELLE DISTELBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 10TH AVE, NEW YORK, NY 10019-1147
(212) 523-2229
Mailing address
140 PHILLIPSBURG RD, GOSHEN, NY 10924-6911
(914) 213-4887
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NY
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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