Provider Demographics
NPI:1114917754
Name:DITTO, KARA E (MD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:E
Last Name:DITTO
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 1:1120 ROUTE 73 STE 300
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-5113
Mailing Address - Country:US
Mailing Address - Phone:800-442-8938
Mailing Address - Fax:856-861-1384
Practice Address - Street 1:1320 CENTRAL PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4953
Practice Address - Country:US
Practice Address - Phone:800-442-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1692342084P0800X
VA01012340722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010006708Medicaid
VAH55271Medicare UPIN
VA002129T42Medicare ID - Type Unspecified