Provider Demographics
NPI:1922084797
Name:DEVITT, DIANNE M (OD)
Entity Type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:M
Last Name:DEVITT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-4603
Practice Address - Street 1:210 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2901
Practice Address - Country:US
Practice Address - Phone:914-682-6560
Practice Address - Fax:914-682-4603
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004276152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133884168OtherPHCS
NYP1256291OtherOXFORD
NY133884168OtherHORIZON HEALTHCARE OF NY
NYC33021OtherBLUE CROSS PPO
NY133884168OtherPOMCO
NY5394167OtherAETNA NON HMO
NY133884168OtherBEECH STREET
NY410041865OtherRAILROAD MEDICARE
NY2C5830OtherHEALTH NET
NY004276OtherHIP
NY042760OtherCONNECTICARE
NY2181842OtherAETNA HMO
NY6599873OtherGHI PPO
NY01953268Medicaid
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY133884168OtherMULTIPLAN
NY5394167OtherAETNA NON HMO
NY6599873OtherGHI PPO