Provider Demographics
NPI:1316939085
Name:ALBIN, RICKEY LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:RICKEY
Middle Name:LEE
Last Name:ALBIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1465
Mailing Address - Country:US
Mailing Address - Phone:732-521-2155
Mailing Address - Fax:732-521-1687
Practice Address - Street 1:15 E RAILROAD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1465
Practice Address - Country:US
Practice Address - Phone:732-521-2155
Practice Address - Fax:732-521-1687
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00282400213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089657Medicare ID - Type Unspecified
NJT11892Medicare UPIN