Provider Demographics
NPI:1023613999
Name:RIFKIND, GITTEL R
Entity type:Individual
Prefix:MRS
First Name:GITTEL
Middle Name:R
Last Name:RIFKIND
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 1:901 PAINTED POST RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3515
Mailing Address - Country:US
Mailing Address - Phone:410-580-1295
Mailing Address - Fax:
Practice Address - Street 1:901 PAINTED POST RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-3515
Practice Address - Country:US
Practice Address - Phone:443-415-5425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10216101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD85-2851538OtherPRIVATE