Provider Demographics
NPI:1366148173
Name:VICENTE RICCI, JOSELYN EMMA
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:EMMA
Last Name:VICENTE RICCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HILL ST APT 501
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4855
Mailing Address - Country:US
Mailing Address - Phone:914-258-7682
Mailing Address - Fax:
Practice Address - Street 1:48 HILL ST APT 501
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4855
Practice Address - Country:US
Practice Address - Phone:914-258-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator