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Individual

ALLISON DEITCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
510 HEMPSTEAD TPKE, ST 202, WEST HEMPSTEAD, NY 11552-1147
(516) 437-6050
(516) 437-6304
Mailing address
510 HEMPSTEAD TPKE, ST 202, WEST HEMPSTEAD, NY 11552-1147
(516) 437-6050
(516) 437-6304

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01666971
NY
Enumeration date
09/21/2011
Last updated
09/21/2011
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