Provider Demographics
NPI:1467432476
Name:DIGNAM, RITCHELL R (MD)
Entity Type:Individual
Prefix:DR
First Name:RITCHELL
Middle Name:R
Last Name:DIGNAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RITCHELL
Other - Middle Name:P
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:220 E 42ND ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5806
Mailing Address - Country:US
Mailing Address - Phone:212-760-3102
Mailing Address - Fax:212-290-3933
Practice Address - Street 1:220 E 42ND ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5806
Practice Address - Country:US
Practice Address - Phone:212-760-3102
Practice Address - Fax:212-290-3933
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07042300207R00000X, 207RG0300X
NJ25MA07042300207RH0002X
NY285636207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04679512Medicaid
NJ8255903Medicaid
NYA400197248OtherNONPARTICIPATING
NJG58214Medicare UPIN