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Individual

JEFFREY R RIDHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
72 RAILROAD PL, SARATOGA SPRINGS, NY 12866-3008
(518) 306-5466
(518) 306-5470
Mailing address
72 RAILROAD PL, SARATOGA SPRINGS, NY 12866-3008
(518) 306-5466
(518) 306-5470

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
229760
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J400072790
MEDICARE PTAN
NY
Enumeration date
11/27/2007
Last updated
12/09/2015
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