Provider Demographics
NPI:1801217963
Name:LITZMAN, SHIFRA (MS)
Entity Type:Individual
Prefix:
First Name:SHIFRA
Middle Name:
Last Name:LITZMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 E CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1720
Mailing Address - Country:US
Mailing Address - Phone:845-821-4122
Mailing Address - Fax:845-364-6770
Practice Address - Street 1:57 E CONCORD DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1720
Practice Address - Country:US
Practice Address - Phone:845-821-4122
Practice Address - Fax:845-364-6770
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0337252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency