Provider Demographics
NPI:1295534360
Name:SITBATMNE LLC
Entity type:Organization
Organization Name:SITBATMNE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVIVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-695-8729
Mailing Address - Street 1:6600 LYNDON B JOHNSON FWY STE 190
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6519
Mailing Address - Country:US
Mailing Address - Phone:214-725-5039
Mailing Address - Fax:
Practice Address - Street 1:6600 LYNDON B JOHNSON FWY STE 190
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6519
Practice Address - Country:US
Practice Address - Phone:214-725-5039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty