Provider Demographics
NPI:1407279094
Name:RICCIO, ARLENE DIANA (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:DIANA
Last Name:RICCIO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:DIANA
Other - Last Name:WITKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:233 LAFAYETTE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5620
Mailing Address - Country:US
Mailing Address - Phone:845-357-5775
Mailing Address - Fax:845-357-5777
Practice Address - Street 1:233 LAFAYETTE AVE STE 204
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5620
Practice Address - Country:US
Practice Address - Phone:845-357-5775
Practice Address - Fax:845-357-5777
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00489800367500000X
NY641467-01367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered