Provider Demographics
NPI:1568524650
Name:RICAFORT, ROSANNA JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:JANE
Last Name:RICAFORT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:41 GLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1625
Mailing Address - Country:US
Mailing Address - Phone:646-262-6032
Mailing Address - Fax:
Practice Address - Street 1:3415 BAINBRIDGE AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2490
Practice Address - Country:US
Practice Address - Phone:718-741-2340
Practice Address - Fax:718-920-6506
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2278692080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology