Provider Demographics
NPI:1740481696
Name:STAVITZ, MARY ELLEN (PNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELLEN
Last Name:STAVITZ
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Gender:F
Credentials:PNP
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Mailing Address - Street 1:50 DAYTON LANE, SUITE 202
Mailing Address - Street 2:THE WESTCHSTER MEDICAL PRACTICE PC
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:35 S RIVERSIDE AVE
Practice Address - Street 2:THE WESTCHESTER M,EDICAL PRACTICE PC
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2653
Practice Address - Country:US
Practice Address - Phone:914-271-2424
Practice Address - Fax:914-271-2551
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-07-18
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Provider Licenses
StateLicense IDTaxonomies
NYF380031363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics