1306002209 NPI number — CHARLOTTE VERONICA BITTERMAN R.N.

Table of content: CHARLOTTE VERONICA BITTERMAN R.N. (NPI 1306002209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306002209 NPI number — CHARLOTTE VERONICA BITTERMAN R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BITTERMAN
Provider First Name:
CHARLOTTE
Provider Middle Name:
VERONICA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIEDL
Provider Other First Name:
CHARLOTTE
Provider Other Middle Name:
VERONICA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306002209
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2543 US ROUTE 20
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAZENOVIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2543 US ROUTE 20
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAZENOVIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13035-8446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-815-4130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  415405-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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