Basic Information
Provider Information
NPI: 1073906657
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RITTMASTER
FirstName: GILLIAN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 845 N BROADWAY
Address2: C/O WJCS
City: WHITE PLAINS
State: NY
PostalCode: 106032403
CountryCode: US
TelephoneNumber: 9147610600
FaxNumber: 9149496778
Practice Location
Address1: 845 N BROADWAY
Address2: C/O WJCS
City: WHITE PLAINS
State: NY
PostalCode: 106032403
CountryCode: US
TelephoneNumber: 9147610600
FaxNumber: 9149496778
Other Information
ProviderEnumerationDate: 03/06/2015
LastUpdateDate: 03/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X089176NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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