Healthcare Provider Details

I. General information

NPI: 1013962331
Provider Name (Legal Business Name): RITTENHOUSE ANESTHESIA ASSOCIATES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S 19TH ST
PHILADELPHIA PA
19146-1449
US

IV. Provider business mailing address

520 S 19TH ST
PHILADELPHIA PA
19146-1449
US

V. Phone/Fax

Practice location:
  • Phone: 215-545-4173
  • Fax: 215-545-1543
Mailing address:
  • Phone: 215-545-4173
  • Fax: 215-545-1543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. MARY KAY JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 215-545-4173