Provider Demographics
NPI:1619972049
Name:RITTER CLINICAL LABORATORIES
Entity Type:Organization
Organization Name:RITTER CLINICAL LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SE
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-356-4257
Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:STE 103
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:
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:STE 103
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2515291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYL82721Medicare ID - Type Unspecified