National Provider Identifier

Katie Lee Dieterle, RPA-C, AAHIVS

Katie Lee Dieterle, RPA-C, AAHIVS is listed in the NPPES registry with a primary specialty of Physician Assistant in Elmira, NY and a listed phone number of (607) 795-8161.

NPI 1003092370Elmira, NYPhysician Assistant

Profile Overview

NPI
1003092370
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
January 16, 2008
Last Updated
November 10, 2023

Practice Location

  • 600 Roe Ave Ste 1F
  • Elmira, NY 14905-1676

Phone: (607) 795-8161

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1003092370
Entity Type
Individual
Last Name
Dieterle
First Name
Katie
Middle Name
Lee
Credential
RPA-C, AAHIVS
Provider Other Last Name
Bachman
Provider Other First Name
Katie
Provider Other Middle Name
Lee
Provider Other Last Name Type Code
1
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 873-1244
Practice Street Address
600 Roe Ave Ste 1F
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1676
Practice Country
US
Practice Phone
(607) 795-8161
Practice Fax
(607) 795-8115
Enumeration Date
January 16, 2008
Last Updated
November 10, 2023
Sex
Female
Sole Proprietor
No
Certification Date
November 10, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
02966498 (NY)