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DR. DIMITRI LADDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
481 S WASHINGTON AVE, BERGENFIELD, NJ 07621-4313
(201) 875-2454
(732) 707-5001
Mailing address
31 LIBERTY ST, PIERMONT, NY 10968-1207
(917) 974-7279

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2288751
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
228875
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
25MA10557500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02461127
NY
01
25MA10557500
NEW JERSEY LICENSE
NJ
Enumeration date
07/08/2006
Last updated
06/18/2023
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