Healthcare Provider Details

I. General information

NPI: 1790554921
Provider Name (Legal Business Name): MICHAEL DAVID RITZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 MONROEVILLE BLVD STE 102
MONROEVILLE PA
15146-2372
US

IV. Provider business mailing address

199 SUNSET DR
PENN HILLS PA
15235-4845
US

V. Phone/Fax

Practice location:
  • Phone: 412-702-9458
  • Fax:
Mailing address:
  • Phone: 412-287-5715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number156588
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: