Ricketts, Mark A

Ricketts, Mark A is an sole proprietor health care provider with primary practice located at 1565 Herzel Blvd , West Babylon NY 11704-4234. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Ricketts, Mark A can be contacted via phone (646) 649-6840.

Contact Information

Primary practice address
1565 Herzel Blvd West Babylon NY 11704-4234
Phone: (646) 649-6840
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F404433 New York

Profile Details

NPI number 1801132782
LBN Legal business name Ricketts, Mark A
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2012
Last updated Sep 28th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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