Provider Demographics
NPI:1124173505
Name:RITTMANIC, PAUL A (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:RITTMANIC
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7724 E HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1622
Mailing Address - Country:US
Mailing Address - Phone:480-357-9198
Mailing Address - Fax:480-357-9198
Practice Address - Street 1:8505 E VALLEY VIEW RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-6768
Practice Address - Country:US
Practice Address - Phone:480-484-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA0358237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ934598Medicaid