Individual
DR. RICKI M HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
695 US HIGHWAY 46, SUITE 400A, FAIRFIELD, NJ 07004-1592
(973) 826-8080
(866) 309-3354
Mailing address
PO BOX 4059, WAYNE, NJ 07474-4059
(973) 894-1263
(888) 972-3703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA03589400
NJ
208600000X
Surgery Physician
Primary
25MA03589400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024155
—
NJ
Enumeration date
02/12/2009
Last updated
01/17/2017
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