Provider Demographics
NPI:1184975062
Name:RITCHIE, TAHIRAH JAMILA (RN)
Entity type:Individual
Prefix:MS
First Name:TAHIRAH
Middle Name:JAMILA
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 E 165TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-6041
Mailing Address - Country:US
Mailing Address - Phone:917-224-5117
Mailing Address - Fax:
Practice Address - Street 1:236 E 165TH ST APT 2C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-6041
Practice Address - Country:US
Practice Address - Phone:917-224-5117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY555274163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse