Provider Demographics
NPI:1083986236
Name:WITTMAN, DEBORAH (PHARM D)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:WITTMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:WITTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 WEST 106TH ST APT 9D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 WEST 106TH ST APT 9D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3672
Practice Address - Country:US
Practice Address - Phone:212-851-1192
Practice Address - Fax:212-851-1011
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist