Provider Demographics
NPI:1790441459
Name:DOBSON, RICKARDO R (NURSE)
Entity Type:Individual
Prefix:MR
First Name:RICKARDO
Middle Name:R
Last Name:DOBSON
Suffix:
Gender:M
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 E 231ST ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-4144
Mailing Address - Country:US
Mailing Address - Phone:347-327-4867
Mailing Address - Fax:
Practice Address - Street 1:761 E 231ST ST APT 2R
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-4144
Practice Address - Country:US
Practice Address - Phone:347-327-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY824704163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty