Provider Demographics
NPI:1770564502
Name:LITMAN, RICHARD STEVEN (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEVEN
Last Name:LITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:560 WHITE PLAINS ROAD - ENTA
Mailing Address - Street 2:SUITE 615
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-6802
Mailing Address - Country:US
Mailing Address - Phone:914-984-2534
Mailing Address - Fax:914-425-0480
Practice Address - Street 1:1500 ROUTE 112
Practice Address - Street 2:BLDG. 4 - 2ND FLOOR
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-8054
Practice Address - Country:US
Practice Address - Phone:631-828-7001
Practice Address - Fax:631-928-0185
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY112673-1207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY653636Medicaid
NYB17704Medicare UPIN
NY653636Medicaid