Provider Demographics
NPI:1710378245
Name:VISPERAS, RICO MIGUEL ALMAZAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICO MIGUEL
Middle Name:ALMAZAN
Last Name:VISPERAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1535
Mailing Address - Country:US
Mailing Address - Phone:862-520-8895
Mailing Address - Fax:
Practice Address - Street 1:50 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1535
Practice Address - Country:US
Practice Address - Phone:862-520-8895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00323600213ES0103X
NYN006652-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery