Provider Demographics
NPI:1336598598
Name:RITTERSHAUS, NICOLE SAVINA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SAVINA
Last Name:RITTERSHAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:SAVINA
Other - Last Name:NORONHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:354 TREMONT STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:617-426-9200
Mailing Address - Fax:
Practice Address - Street 1:354 TREMONT STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:617-426-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278501208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics