Provider Demographics
NPI:1932199858
Name:RITWIK, CRISTIANA MORENA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:CRISTIANA
Middle Name:MORENA
Last Name:RITWIK
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:CRISTIANA
Other - Middle Name:
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 RESERVOIR AVE STE 2G
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-3594
Mailing Address - Country:US
Mailing Address - Phone:401-632-4470
Mailing Address - Fax:401-632-4470
Practice Address - Street 1:747 PONTIAC AVE
Practice Address - Street 2:STE 214
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5825
Practice Address - Country:US
Practice Address - Phone:401-632-4470
Practice Address - Fax:401-632-4470
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00509364SP0809X
RIAPRN01519363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1038660OtherBEACON HEALTH STRATEGIES
RIAPRN00509OtherRI ADVANCED PRACTICE NURING LICENSE
CAPRN00509OtherRHODE ISLAND CONTROLLED SUBSTANCE REGISTRATION
RICAPRN01519OtherRI CONTROLLED SUBSTANCE REGISTRATION
RI21585-9OtherBLUE CROSS BLUE SHIELD
RI410117OtherBLUE CHIP
RI2220656OtherCIGNA
RI899004015OtherMEDICARE PTAN
RIAPRN01519OtherRHODE ISLAND PROFESSIONAL LICENSE
RI21585-9OtherBLUE CROSS BLUE SHIELD
RIAPRN00509OtherRI ADVANCED PRACTICE NURING LICENSE