Healthcare Provider Details

I. General information

NPI: 1235360934
Provider Name (Legal Business Name): RICARDO DAVID BUDJAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MADISON AVE FL 2
NEW YORK NY
10010-1600
US

IV. Provider business mailing address

3911 HEATHER DR
WILMINGTON DE
19807-2117
US

V. Phone/Fax

Practice location:
  • Phone: 855-629-0554
  • Fax:
Mailing address:
  • Phone: 904-553-8784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD447490
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC1-0025640
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME159548
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0090762
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number319925
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA124923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: