Provider Demographics
NPI:1497030316
Name:BITTINGER, DIANNE DOROTHY (RN)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:DOROTHY
Last Name:BITTINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DIANNE
Other - Middle Name:DOROTHY
Other - Last Name:BITTINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1416 PONTIAC RD
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:NY
Mailing Address - Zip Code:14006-9527
Mailing Address - Country:US
Mailing Address - Phone:716-549-2300
Mailing Address - Fax:716-549-4033
Practice Address - Street 1:959 BEACH RD
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:NY
Practice Address - Zip Code:14006-9702
Practice Address - Country:US
Practice Address - Phone:716-549-2300
Practice Address - Fax:716-549-4033
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262761163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool