Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | C02326 | NY |
N | 111NI0013X | Independent Medical Examiner | C02326 | NY |
NPI | 1780987669 |
---|---|
Provider Name | Dr. Jeffrey Ritholtz |
First Address | Valley Stream, NY 11580-5913 |
Second Address | Valley Stream, NY 11580-5913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 14/12/2010 |