Provider Demographics
NPI:1164663050
Name:RITTENHOUSE PLASTIC SURGERY, P.C.
Entity type:Organization
Organization Name:RITTENHOUSE PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALGIRD
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:MAMENISKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-732-3340
Mailing Address - Street 1:255 S 17TH ST STE 2200
Mailing Address - Street 2:MEDICAL TOWER BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6221
Mailing Address - Country:US
Mailing Address - Phone:215-732-3340
Mailing Address - Fax:215-732-3160
Practice Address - Street 1:255 S 17TH ST STE 2200
Practice Address - Street 2:MEDICAL TOWER BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6221
Practice Address - Country:US
Practice Address - Phone:215-732-3340
Practice Address - Fax:215-732-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041644E261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty