Provider Demographics
NPI:1487084935
Name:PINEDA, RICA O (DNP, FNP-BC, RN)
Entity type:Individual
Prefix:DR
First Name:RICA
Middle Name:O
Last Name:PINEDA
Suffix:
Gender:F
Credentials:DNP, FNP-BC, RN
Other - Prefix:DR
Other - First Name:RICA
Other - Middle Name:O
Other - Last Name:PINEDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, RN, FNP-BC
Mailing Address - Street 1:75 LIVERPOOL WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-4024
Mailing Address - Country:US
Mailing Address - Phone:856-296-5109
Mailing Address - Fax:856-757-3719
Practice Address - Street 1:42 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-325-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11176600363LF0000X, 163WG0000X
PASP015252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily