Provider Demographics
NPI:1255752929
Name:RITCHIE, DELORIS
Entity type:Individual
Prefix:
First Name:DELORIS
Middle Name:
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DELORIS
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:10 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2216
Mailing Address - Country:US
Mailing Address - Phone:845-406-3859
Mailing Address - Fax:
Practice Address - Street 1:10 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2216
Practice Address - Country:US
Practice Address - Phone:845-406-3859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267893164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse