MR. Mark A Ricketts, PMHNP
NPI #1801132782 in West Babylon, New York
Provider Information
- NPI Number
- 1801132782
- Entity Type
- Individual
- Name
- MR. Mark A Ricketts, PMHNP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Credential
- PMHNP
- Enumeration Date
- Dec 20, 2012
- Last Updated
- Sep 28, 2022
Practice Location
- Address
- 1565 HERZEL BLVD
- City
- West Babylon
- State
- New York
- ZIP Code
- 11704-4234
- Phone
- (646) 649-6840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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