Provider Demographics
NPI:1932683844
Name:PITTER, CINDY HEATHER
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:HEATHER
Last Name:PITTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2102
Mailing Address - Country:US
Mailing Address - Phone:212-569-1044
Mailing Address - Fax:212-569-1066
Practice Address - Street 1:4624 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-2102
Practice Address - Country:US
Practice Address - Phone:212-569-1044
Practice Address - Fax:212-569-1066
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCERTIFIEC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist