Provider Demographics
NPI:1154496669
Name:PITTMAN, JANET ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ELAINE
Last Name:PITTMAN
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 1:173 BEACH 132ND STREET
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1407
Mailing Address - Country:US
Mailing Address - Phone:718-474-7846
Mailing Address - Fax:
Practice Address - Street 1:173 BEACH 132ND STREET
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1407
Practice Address - Country:US
Practice Address - Phone:718-474-7846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197964207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F75172Medicare UPIN