Individual
MS. LOU ANN DIPETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
600 ROE AVENUE, SUITE 1G, ELMIRA, NY 14905-1629
(607) 795-2820
(607) 795-2821
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
305077
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
305077
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03102325
—
NY
05
—
103181065
—
PA
01
—
P01181372
RAILROAD MEDICARE
NY
Enumeration date
03/18/2009
Last updated
04/17/2023
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