Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1073503520 |
---|---|
Provider Name | Mr. William J Ritter |
First Address | Monroeville, PA 15146-3539 |
Second Address | Monroeville, PA 15146-3539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RI283496 | HIGHMARK (01) | PA |