Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. BETTINA S. NIEDERER MD
NPI 1174560684
Pediatrics in Lake Ronkonkoma, NY

Active since June 01, 2006
640 HAWKINS AVE, LAKE RONKONKOMA, NY 11779(631) 737-0100(631) 417-1117 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Bettina S. Niederer Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BETTINA S. NIEDERER MD (NPI 1174560684) is an individual pediatrics provider in Lake Ronkonkoma, New York, licensed in New York (136981) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1174560684
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. BETTINA S. NIEDERERCredential: MD
Location Address640 HAWKINS AVELake Ronkonkoma, NY 11779-2324
Mailing Address640 Hawkins AveLake Ronkonkoma, NY 11779-2324 · (631) 737-0100 · Fax (631) 417-1117
Fax(631) 417-1117
Sole ProprietorNo
Enumeration DateJune 1, 2006
Last NPPES UpdateJuly 13, 2026
NPI 1174560684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in NY · 136981
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

640 HAWKINS AVE, Lake Ronkonkoma, NY 11779

Other Identifiers 1

Medicaid00821994NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Pharmacist
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Internal Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Internal Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Family Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Family Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Dermatology
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Internal Medicine
640 HAWKINS AVE
LAKE RONKONKOMA, NY 11779

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bettina Niederer's NPI number?

The NPI number for Bettina Niederer is 1174560684. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Bettina Niederer located?

Bettina Niederer practices at 640 Hawkins Ave, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 737-0100.

What is Bettina Niederer's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Bettina Niederer was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.