=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083750822
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER ELAINE RITTER PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2007
-----------------------------------------------------
Last Update Date | 03/25/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 815 FREEPORT RD 200 BUILDING, SUITE 4000
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15215-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-784-5010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 212 MALLARD DR
-----------------------------------------------------
City | MONROEVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15146-1144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-372-0328
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT001341E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------