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Organization

AM RICCIARDI

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TANYA MCFADDEN (MEDICAL ASSISTANT)
(973) 678-3133
Entity
Organization

Contact information

Practice address
172 HALSTED ST, EAST ORANGE, NJ 07018-2663
(973) 678-3133
Mailing address
172 HALSTED ST, EAST ORANGE, NJ 07018-2663

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3564400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3097102
NJ
Enumeration date
07/17/2014
Last updated
07/17/2014
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