RENA MARIE RICCARDI (NPI# 1962988543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962988543 |
Entity Type | Individual |
Full Name | RENA MARIE RICCARDI |
Credential | MS, RD, CDE |
Practice Address |
255 Lafayette Ave Suffern NY 10901-4869 |
Mailing Address |
4 Juniper Dr Lake Lincolndale NY 10541-5300 |
Practice Telephone | 9147721005 |
Practice Fax Number | 8455473357 |
Mailing Telephone | 9147721005 |
Mailing Fax Number | 9145566356 |
Enumeration Date | 2018-07-17 |
Last Update Date | 2018-07-17 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
724462 | Dietary & Nutritional Service Providers | |
Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
724462 | Dietary & Nutritional Service Providers | |
N | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
217003387 | NY | Allopathic & Osteopathic Physicians |
N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
N | 174H00000X | Health Educator | Other Service Providers | ||
N | 2080B0002X |
Pediatrics Specialization: Obesity Medicine |
724462 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCBDE | 21700387 | 01 | |
CDR | 724462 | 01 |
Street Address |
255 LAFAYETTE AVE |
City | SUFFERN |
State | NY |
Zip Code | 10901-4869 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184616963 | Martin S Katzenstein | Pediatrics | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2005-08-18 |
1184232894 | Jennifer Peterson | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2020-07-20 |
1396360186 | Tina George | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2020-06-08 |
1053943902 | Michelle Lindsay Mathew | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2020-02-09 |
1174155162 | Rockland Physician Medicine Services, P.C. | Physician Assistant | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2020-02-07 |
1659847416 | Teresa Ann Sullivan | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2018-10-19 |
1134694334 | Damar Titsy-ann Mcintyre | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2018-10-04 |
1730638453 | Patricia Margaret Kivlehan | Nurse Practitioner | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2016-09-22 |
1609251370 | Melissa Theodore | Physical Therapist | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2015-07-23 |
1013392927 | Holly Durniak | Speech-Language Pathologist | 255 Lafayette Ave, Suffern, NY 10901-4812 | 2015-07-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740895309 | Constance Marie Princiotto | Registered Nurse | J&d Ultracare, 15 Suffern Pl, Suffern, NY 10901 | 2020-09-10 |
1376101790 | Tenika Filomena Walters | Licensed Practical Nurse | 15 Suffen Place, Suffen, NY 10901 | 2019-05-31 |
1922563261 | Matthew Abel | Dietitian, Registered | 156 Ny-59, A2, Suffern, NY 10901 | 2019-01-31 |
1609349422 | Yona Newmark | Behavioral Analyst | 84 Route 59 Suite 102, Suffern, NY 10901 | 2019-01-03 |
1235606005 | William M Mazariego | Specialist/Technologist | 5 Tallman Pl, Suffern, NY 10901 | 2018-10-30 |
1396237228 | Stephanie N Freer | Registered Nurse | 15 Suffern Pl., Suffern, NY 10901 | 2018-06-06 |
1588102669 | Lisa Arcuri | Registered Nurse | 15 Suffern Place Ste A, Suffern, NY 10901 | 2017-02-08 |
1801342787 | Maria Castro-cancel | Social Worker | 58 Campbell Avenue, Airmont, NY 10901 | 2016-08-30 |
1811341530 | Simone Raven Pringle | Licensed Practical Nurse | 15 Suffern Place, Suite A, Suffern, NY 10901 | 2016-04-19 |
1871998666 | Simi Samuel | Specialist | 13 Hillside Ct, Suffern, NY 10901 | 2014-10-23 |
Find all providers in zip 10901 |
Taxonomy Code | 133VN1006X |
Grouping | Dietary & Nutritional Service Providers |
Classification | Dietitian, Registered |
Specialization | Nutrition, Metabolic |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891308276 | Jennifer Nicole Arnette | Dietitian, Registered | 1207 Delaware Ave Ste 114, Buffalo, NY 14209-1458 | 2020-08-26 |
1487200358 | Jackie Carlson, Rd, Ldn, Cde Diabetes Consultant, LLC | Dietitian, Registered | 4867 College St, Ashville, NY 14710-9603 | 2019-08-15 |
1093219586 | Nutrition Link Services, LLC | Dietitian, Registered | 50 Jeanne Dr, Newburgh, NY 12550-1701 | 2018-03-20 |
1275037749 | Jo Ann Brown | Dietitian, Registered | 2233 Caton Ave Apt 6a, Brooklyn, NY 11226-2588 | 2018-03-20 |
1881101954 | Western New York Integrated Care Collaborative, Inc. | Dietitian, Registered | 742 Delaware Avenue, Buffalo, NY 14209 | 2018-01-10 |
1770994741 | Juliana Martinez | Dietitian, Registered | 430 West 34th St, Apt. 3k, New York, NY 10001-2310 | 2014-05-13 |
1912338120 | Kelly Elaine Gumpel | Dietitian, Registered | 60 Paulding Ave, Tarrytown, NY 10591-5713 | 2013-12-13 |
1467898528 | Ilona Ginevic | Dietitian, Registered | One Gustave L. Levy Place, Box 1497, New York, NY 10029 | 2013-05-16 |
1114286887 | Ilene Frischer | Dietitian, Registered | 560 Northern Blvd Suite207, Great Neck, NY 11021 | 2012-05-15 |
1033492582 | His Rhema Nutrition Services, LLC | Dietitian, Registered | 9050 Parsons Blvd Ste 304, Jamaica, NY 11432-6052 | 2011-09-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.