Riccobono, Charles Anthony

Riccobono, Charles Anthony is an individual health care provider with primary practice located at 20 Prospect Ave Suite 915, Hackensack NJ 07601. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Riccobono, Charles Anthony can be contacted via phone (201) 342-9119.

Contact Information

Primary practice address
20 Prospect Ave Suite 915 Hackensack NJ 07601
Phone: (201) 342-9119
Fax: (201) 342-3735
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MA24007 New Jersey
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MA24007 New Jersey

Profile Details

NPI number 1215900527
LBN Legal business name Riccobono, Charles Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215900527 NPPES
New Jersey MEDICAID 1415301

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