Provider Demographics
NPI:1699976720
Name:RITZER, GAYLE (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:
Last Name:RITZER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WEXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-5591
Mailing Address - Country:US
Mailing Address - Phone:908-575-0444
Mailing Address - Fax:
Practice Address - Street 1:570 LEE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3053
Practice Address - Country:US
Practice Address - Phone:732-442-1666
Practice Address - Fax:732-442-9512
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007480001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
640653CYQMedicare PIN