Niederer, Bettina S.

Niederer, Bettina S. is an individual health care provider with primary practice located at 640 Hawkins Ave , Lake Ronkonkoma NY 11779-2324. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Niederer, Bettina S. can be contacted via phone (631) 737-0100.

Contact Information

Primary practice address
640 Hawkins Ave Lake Ronkonkoma NY 11779-2324
Phone: (631) 737-0100
Fax: (631) 417-1117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 136981 New York

Profile Details

NPI number 1174560684
LBN Legal business name Niederer, Bettina S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174560684 NPPES
New York MEDICAID 00821994

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