Provider Demographics
NPI:1699016378
Name:SELL, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5757
Mailing Address - Country:US
Mailing Address - Phone:716-626-3493
Mailing Address - Fax:716-204-8286
Practice Address - Street 1:100 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5757
Practice Address - Country:US
Practice Address - Phone:716-626-3493
Practice Address - Fax:716-204-8286
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21555Medicaid
NY21577OtherDEPARTMENT OF HELTH EARLY INTERVENTION