| Doctor Name: | MRS. AMY BETH DITZEL |
| NPI Number: | 1083869192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MS, NNP |
| License Number: | 260488 |
| Business Practice Address: | 55 Fogg Rd Weymouth, MA - 021902432 |
| Business Phone Number: | 7813408373 |
| Business Fax Number: | 7813403447 |
| Mailing Address: | 55 Fogg Rd, WEYMOUTH |
| State: | MA |
| Postal Code: | 021902432 |
| Phone Number: | 7813408373 |
| Fax Number: | 7813403447 |
| NPI Enumeration Date: | 11/18/2008 |
| NPI Last Update Date: | 11/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | 260488 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |