Provider Demographics
NPI:1073503520
Name:RITTER, WILLIAM J (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:RITTER
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
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Mailing Address - Street 1:2520 MOSSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3539
Mailing Address - Country:US
Mailing Address - Phone:412-372-5632
Mailing Address - Fax:412-843-0016
Practice Address - Street 1:2520 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3539
Practice Address - Country:US
Practice Address - Phone:412-372-5632
Practice Address - Fax:412-843-0016
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2007-11-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARI283496OtherHIGHMARK
PA1171620001Medicare ID - Type UnspecifiedI.D.