Provider Demographics
NPI:1073935672
Name:RIBARIC, DORIS (MSED)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:RIBARIC
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CORWIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3911
Mailing Address - Country:US
Mailing Address - Phone:516-589-9702
Mailing Address - Fax:
Practice Address - Street 1:16 CORWIN AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3911
Practice Address - Country:US
Practice Address - Phone:516-589-9702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY825200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist