Healthcare Provider Details

I. General information

NPI: 1356428403
Provider Name (Legal Business Name): DIANE BETH RITTER M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 125TH ST HARLEM MEDICAL GROUP
NEW YORK NY
10027-4512
US

IV. Provider business mailing address

4051 ESTANCIA WAY
MELBOURNE FL
32934-8709
US

V. Phone/Fax

Practice location:
  • Phone: 212-289-5795
  • Fax: 212-410-4424
Mailing address:
  • Phone: 914-325-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number155078
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: