Healthcare Provider Details

I. General information

NPI: 1588152177
Provider Name (Legal Business Name): ALISON P RICARDO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2018
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

1216 PINE TREE WAY
BELMAR NJ
07719-2846
US

V. Phone/Fax

Practice location:
  • Phone: 201-608-2800
  • Fax:
Mailing address:
  • Phone: 908-477-7626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number25MA13246000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: