Provider Demographics
NPI:1285885277
Name:RICCIARDI, RALPH E JR (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:E
Last Name:RICCIARDI
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:7312 BERGENLINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047
Mailing Address - Country:US
Mailing Address - Phone:201-861-9422
Mailing Address - Fax:201-295-2932
Practice Address - Street 1:7312 BERGENLINE AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:201-861-9422
Practice Address - Fax:201-295-2932
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03139600207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD06400Medicare UPIN
NJ475622Medicare Oscar/Certification