Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 172562 | NY |
NPI | 1164432902 |
---|---|
Provider Name | Jacalyn Bitterman |
First Address | Bronx, NY 10459-2417 |
Second Address | Bronx, NY 10459-2417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 20/06/2011 |