Provider Demographics
NPI:1629318811
Name:STEVEN GITT MD PC
Entity Type:Organization
Organization Name:STEVEN GITT MD PC
Other - Org Name:NORTH VALLEY PLASTIC SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:M.D/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-991-6877
Mailing Address - Street 1:20950 N TATUM BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4250
Mailing Address - Country:US
Mailing Address - Phone:480-991-6877
Mailing Address - Fax:480-991-6615
Practice Address - Street 1:20950 NORTH TATUM BOULEVARD
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:480-991-6877
Practice Address - Fax:480-991-6615
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH VALLEY OUTPATIENT SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-25
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3737261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZMD17134Medicare PIN
AZD43965Medicare UPIN