Provider Demographics
NPI:1235312026
Name:RITTER CLINICAL LABORATORY
Entity Type:Organization
Organization Name:RITTER CLINICAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SE
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTER-HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-356-4257
Mailing Address - Street 1:222 ROUTE 59 STE 103
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5207
Mailing Address - Country:US
Mailing Address - Phone:845-356-4257
Mailing Address - Fax:845-357-5941
Practice Address - Street 1:222 ROUTE 59 STE 103
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5207
Practice Address - Country:US
Practice Address - Phone:845-356-4257
Practice Address - Fax:845-357-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2515291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYL82721OtherMEDICARE BILLING ID