Provider Demographics
NPI:1841078961
Name:RICCA, JULIANNE BEA (MS)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:BEA
Last Name:RICCA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 OAK TER
Mailing Address - Street 2:
Mailing Address - City:LAKE COMO
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2785
Practice Address - Country:US
Practice Address - Phone:201-403-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS