Provider Demographics
NPI:1134189301
Name:RICCARDI, CHRISTINE DARAGJATI (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:DARAGJATI
Last Name:RICCARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:HELEN
Other - Last Name:DARAGJATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6229
Mailing Address - Country:US
Mailing Address - Phone:978-373-6557
Mailing Address - Fax:978-374-5096
Practice Address - Street 1:2 WATER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6229
Practice Address - Country:US
Practice Address - Phone:978-373-6557
Practice Address - Fax:978-374-5096
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics