Provider Demographics
NPI:1831123991
Name:JOHN, RITAMARIE I (CDNP DR NP)
Entity Type:Individual
Prefix:DR
First Name:RITAMARIE
Middle Name:I
Last Name:JOHN
Suffix:
Gender:F
Credentials:CDNP DR NP
Other - Prefix:
Other - First Name:RITAMARIE
Other - Middle Name:
Other - Last Name:LEGGIADRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:9 CORLE PLACE
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844
Mailing Address - Country:US
Mailing Address - Phone:908-369-7501
Mailing Address - Fax:
Practice Address - Street 1:435 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208
Practice Address - Country:US
Practice Address - Phone:908-659-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04791200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P12129Medicare UPIN