Basic Information
| Provider Information | |||||||||
| NPI: | 1922084797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEVITT | ||||||||
| FirstName: | DIANNE | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146813146 | ||||||||
| FaxNumber: | 9146824603 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146826560 | ||||||||
| FaxNumber: | 9146824603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 10/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 004276 | NY | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 133884168 | 01 | NY | PHCS | OTHER | P1256291 | 01 | NY | OXFORD | OTHER | 133884168 | 01 | NY | HORIZON HEALTHCARE OF NY | OTHER | C33021 | 01 | NY | BLUE CROSS PPO | OTHER | 133884168 | 01 | NY | POMCO | OTHER | 5394167 | 01 | NY | AETNA NON HMO | OTHER | 133884168 | 01 | NY | BEECH STREET | OTHER | 410041865 | 01 | NY | RAILROAD MEDICARE | OTHER | 2C5830 | 01 | NY | HEALTH NET | OTHER | 004276 | 01 | NY | HIP | OTHER | 042760 | 01 | NY | CONNECTICARE | OTHER | 2181842 | 01 | NY | AETNA HMO | OTHER | 6599873 | 01 | NY | GHI PPO | OTHER | 01953268 | 05 | NY | MEDICAID | 133884168 | 01 | NY | EMPIRE STATE PLAN (NYS) | OTHER | 133884168 | 01 | NY | MULTIPLAN | OTHER |