Healthcare Provider Details

I. General information

NPI: 1477663243
Provider Name (Legal Business Name): RITCHIE J PARROTTA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 W SAND LAKE RD
WYNANTSKILL NY
12198-7954
US

IV. Provider business mailing address

9 W SAND LAKE RD
WYNANTSKILL NY
12198-7954
US

V. Phone/Fax

Practice location:
  • Phone: 518-283-1974
  • Fax: 518-283-2018
Mailing address:
  • Phone: 518-283-1974
  • Fax: 518-283-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number166285
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: