Provider Demographics
NPI:1316716558
Name:NIEDERRITER, SCOTT
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:NIEDERRITER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 N HOLLAND SYLVANIA RD APT 69
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2571
Mailing Address - Country:US
Mailing Address - Phone:419-343-8019
Mailing Address - Fax:
Practice Address - Street 1:4615 N HOLLAND SYLVANIA RD APT 69
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2571
Practice Address - Country:US
Practice Address - Phone:419-343-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker