National Provider Identifier

Bill David Dienstag, PAC

Bill David Dienstag, PAC is listed in the NPPES registry with a primary specialty of Physician Assistant in Elmira, NY and a listed phone number of (607) 737-7780.

NPI 1104120575Elmira, NYPhysician Assistant

Profile Overview

NPI
1104120575
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
December 29, 2010
Last Updated
March 07, 2023

Practice Location

  • 600 Ivy St
  • Suite 201
  • Elmira, NY 14905-1627

Phone: (607) 737-7780

Mailing Address

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

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1104120575
Entity Type
Individual
Last Name
Dienstag
First Name
Bill
Middle Name
David
Name Prefix
Mr.
Credential
PAC
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
Practice Street Address
600 Ivy St
Practice Address Line 2
Suite 201
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1627
Practice Country
US
Practice Phone
(607) 737-7780
Practice Fax
(607) 737-7788
Enumeration Date
December 29, 2010
Last Updated
March 07, 2023
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
006144 (NY, Ny State License), 04297325 (NY)