Provider Demographics
NPI:1225343528
Name:DITMAN, BARBARA ANNE
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:DITMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANNE
Other - Last Name:BORNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC/SLP
Mailing Address - Street 1:7740 VLEIGH PL
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3360
Mailing Address - Country:US
Mailing Address - Phone:718-591-9093
Mailing Address - Fax:
Practice Address - Street 1:7740 VLEIGH PL
Practice Address - Street 2:
Practice Address - City:KEW GARDENS HILLS
Practice Address - State:NY
Practice Address - Zip Code:11367-3360
Practice Address - Country:US
Practice Address - Phone:718-591-9093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006105-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist