Provider Demographics
NPI:1790554921
Name:RITZ, MICHAEL DAVID
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:RITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4845
Mailing Address - Country:US
Mailing Address - Phone:412-287-5715
Mailing Address - Fax:
Practice Address - Street 1:2526 MONROEVILLE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2372
Practice Address - Country:US
Practice Address - Phone:412-702-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 235500000X, 374700000X
PA156588146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No172V00000XOther Service ProvidersCommunity Health Worker
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No374700000XNursing Service Related ProvidersTechnician