Individual
ELIZABETH SIDOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020100
NYS LICENSE
NY
Enumeration date
09/21/2016
Last updated
09/21/2016
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