Healthcare Provider Details

I. General information

NPI: 1134849912
Provider Name (Legal Business Name): MIKHALA M RITZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6507 TRANSIT RD STE A
EAST AMHERST NY
14051-1427
US

IV. Provider business mailing address

6507 TRANSIT RD STE A
EAST AMHERST NY
14051-1427
US

V. Phone/Fax

Practice location:
  • Phone: 716-689-4377
  • Fax: 716-689-4843
Mailing address:
  • Phone: 716-689-4377
  • Fax: 716-689-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number028451
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number028451
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: