Provider Demographics
NPI:1255337267
Name:HITTMAN, MARK HOWARD (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:HOWARD
Last Name:HITTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 CROMPOND RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4156
Mailing Address - Country:US
Mailing Address - Phone:914-737-5315
Mailing Address - Fax:914-737-7643
Practice Address - Street 1:1989 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4156
Practice Address - Country:US
Practice Address - Phone:914-737-5315
Practice Address - Fax:914-737-7643
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY98A061Medicare ID - Type Unspecified