Provider Demographics
NPI:1841521994
Name:RITTER, RUXANDRA IRINA (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:RUXANDRA
Middle Name:IRINA
Last Name:RITTER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-0013
Mailing Address - Country:US
Mailing Address - Phone:908-310-7173
Mailing Address - Fax:
Practice Address - Street 1:340 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:908-310-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00499300101YP2500X
NJ35SI00574500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701OtherAGENCY MEDICAID PROVIDER NUMBER
NJ7794703OtherAGENCY PROGRAM PROVIDER MEDICAID #
NJ527486OtherAGENCY MEDICARE PROVIDER #