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Organization
ELLEN RICCARDI, LLC
Active
Organization
ELLEN RICCARDI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CULLEN (MEDICAL BILLING MANAGER)
(203) 368-5515
Entity
Organization
Contact information
Practice address
1214 POST RD, FAIRFIELD, CT 06824-6008
(973) 879-8289
Mailing address
528 BREWSTER ST, BRIDGEPORT, CT 06605-3411
(973) 879-8289
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
08/13/2019
Last updated
08/13/2019
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