MEDICARE: RITTER CLINICAL LABORATORY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	2515	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L82721	OTHER	NY	MEDICARE BILLING ID

General Provider Information

NPI Number	:	1235312026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITTER CLINICAL LABORATORY

Provider Business Mailing Address
First Line	:	222 ROUTE 59 STE 103
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5207
Country	:	US
Telephone Number	:	845-356-4257
Fax Number	:	845-357-5941

Provider Business Practice Location Address
First Line	:	222 ROUTE 59 STE 103
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5207
Country	:	US
Telephone Number	:	845-356-4257
Fax Number	:	845-357-5941

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SE RITTER-HELLER
Credential	:
Telephone Number	:	845-356-4257

Provider Enumeration Date	:	12/14/2007
Last Update Date	:	12/14/2007

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Directions to “RITTER CLINICAL LABORATORY ” Practice Location

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