Individual
HENRIETA RICCOBONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-4387
Mailing address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-4387
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ01183100
NJ
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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