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NPI Code Detail

MEDICARE: DR. ANTHONY MICHAEL RICCIARDI JR. MD

MEDICARE:  DR. ANTHONY MICHAEL RICCIARDI JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1164485314
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY MICHAEL RICCIARDI JR. MD
Provider Business Mailing Address
First Line : 172 HALSTED ST
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2663
Country : US
Telephone Number : 973-678-3133
Fax Number : 973-678-6305
Provider Business Practice Location Address
First Line : 172 HALSTED ST
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2663
Country : US
Telephone Number : 973-678-3133
Fax Number : 973-678-6305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/09/2007

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Directions to “ DR. ANTHONY MICHAEL RICCIARDI JR. MD” Practice Location

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