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Individual

RIKKI REDONA RACELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25 ROCKWOOD PL, #110, ENGLEWOOD, NJ 07631-4957
(201) 894-5805
Mailing address
25 ROCKWOOD PL, #110, ENGLEWOOD, NJ 07631-4957
(201) 894-5805

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
258850
NY
2084N0400X
Neurology Physician
Primary
25MA09073400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
258850
NY STATE EDUCATION DEPT. OFFICE OF THE PROFESSIONS
NY
01
25MA09073400
NJ BOARD OF MEDICAL EXAMINERS
NJ
Enumeration date
07/18/2007
Last updated
04/16/2012
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