Provider Demographics
NPI:1033485024
Name:LITZ, CRISTEN (MD)
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:
Last Name:LITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HOLLAND CIRCLE DR.
Mailing Address - Street 2:SURGICAL HEALTH
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7550
Mailing Address - Country:US
Mailing Address - Phone:518-843-6914
Mailing Address - Fax:518-843-6815
Practice Address - Street 1:119 HOLLAND CIRCLE DR.
Practice Address - Street 2:SURGICAL HEALTH
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7550
Practice Address - Country:US
Practice Address - Phone:518-843-6914
Practice Address - Fax:518-843-6815
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120627208600000X
NY306894208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery