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General NPI Number Information
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NPI Number | 1023071982
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Entity Type | Individual
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Provider Name | MARC FRANCIS RICCARDI DPT
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 150 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1686
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Country | US
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Telephone | 908-340-4772
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Fax | 908-340-4774
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Provider Business Mailing Address
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Address Line | 150 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1686
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Country | US
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Telephone | 908-340-4772
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Fax | 908-340-4774
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | QA9717
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License Number State | NJ
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