Healthcare Provider Details

I. General information

NPI: 1881400190
Provider Name (Legal Business Name): MICHAEL RITUPER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 SCHOOL RD
HORSHAM PA
19044-1850
US

IV. Provider business mailing address

29 SCHOOL RD
HORSHAM PA
19044-1850
US

V. Phone/Fax

Practice location:
  • Phone: 215-208-9836
  • Fax:
Mailing address:
  • Phone: 215-208-9836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number160342
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN708484
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: