Provider Demographics
NPI:1609167543
Name:RICKARDS, JOHN F (RD, LDN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:RICKARDS
Suffix:
Gender:M
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2630
Mailing Address - Country:US
Mailing Address - Phone:215-677-0400
Mailing Address - Fax:
Practice Address - Street 1:601 RIGHTERS FERRY RD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1305
Practice Address - Country:US
Practice Address - Phone:610-664-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004512133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered