Provider Demographics
NPI:1013962331
Name:RITTENHOUSE ANESTHESIA ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:RITTENHOUSE ANESTHESIA ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-545-4173
Mailing Address - Street 1:520 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1449
Mailing Address - Country:US
Mailing Address - Phone:215-545-4173
Mailing Address - Fax:215-545-1543
Practice Address - Street 1:520 S 19TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1449
Practice Address - Country:US
Practice Address - Phone:215-545-4173
Practice Address - Fax:215-545-1543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017446700001Medicaid
PA025650Medicare ID - Type Unspecified