Healthcare Provider Details

I. General information

NPI: 1790013464
Provider Name (Legal Business Name): RITVIJ MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 E 233RD ST
BRONX NY
10466-2802
US

IV. Provider business mailing address

PO BOX 24
MONTVALE NJ
07645-0024
US

V. Phone/Fax

Practice location:
  • Phone: 718-325-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number193352
License Number StateNY

VIII. Authorized Official

Name: VIJAY KHATIWALA
Title or Position: MD
Credential:
Phone: 718-325-3500