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NPI Code Detail

MEDICARE: NATASHA J RICKETTS

MEDICARE:   NATASHA J RICKETTS
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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1285382259
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA J RICKETTS
Provider Business Mailing Address
First Line : 122 CURIE AVE APT 1
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-1656
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 122 CURIE AVE APT 1
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-1656
Country : US
Telephone Number : 973-618-6603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2022
Last Update Date : 03/17/2022

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Directions to “ NATASHA J RICKETTS ” Practice Location

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