Dietz, Jill R

Dietz, Jill R is an individual health care provider with primary practice located at 1111 Franklin Ave , Garden City NY 11530-1617. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Dietz, Jill R can be contacted via phone (516) 663-1950.

Contact Information

Primary practice address
1111 Franklin Ave Garden City NY 11530-1617
Phone: (516) 663-1950
Fax: (516) 741-3562
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD474935 Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X 333332 New York

Profile Details

NPI number 1487672945
LBN Legal business name Dietz, Jill R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Oct 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487672945 NPPES
Other 15405815 CAQH

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