Provider Demographics
NPI:1134849912
Name:RITZ, MIKHALA M (PA-C)
Entity type:Individual
Prefix:
First Name:MIKHALA
Middle Name:M
Last Name:RITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 TRANSIT RD STE A
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1427
Mailing Address - Country:US
Mailing Address - Phone:716-689-4377
Mailing Address - Fax:716-689-4843
Practice Address - Street 1:6507 TRANSIT RD STE A
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1427
Practice Address - Country:US
Practice Address - Phone:716-689-4377
Practice Address - Fax:716-689-4843
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028451207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty