Provider Demographics
NPI:1922472760
Name:RITZER, GILLIAN RUPP
Entity Type:Individual
Prefix:MRS
First Name:GILLIAN
Middle Name:RUPP
Last Name:RITZER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GILLIAN
Other - Middle Name:MARIE
Other - Last Name:RUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:572 POWDERHORN RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3069
Mailing Address - Country:US
Mailing Address - Phone:610-417-9707
Mailing Address - Fax:
Practice Address - Street 1:207 W SUMMIT ST
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-2054
Practice Address - Country:US
Practice Address - Phone:215-723-9881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program