CHARLES ANTHONY RICCOBONO MD NPI 1215900527

NPI Information

  • NPI: 1215900527
  • Provider Name: CHARLES ANTHONY RICCOBONO, MD
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 20 PROSPECT AVE
    SUITE 915
    HACKENSACK, NJ
    ZIP 07601
  • Phone: (201) 342-9119

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NPI Details

Charles Anthony Riccobono, MD is a gastroenterology internal medicine in Hackensack, NJ. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Charles Anthony Riccobono, MD NPI is 1215900527. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20 PROSPECT AVE
SUITE 915
HACKENSACK, NJ
ZIP 07601
Phone: (201) 342-9119
Fax: (201) 342-3735

The NPI 1215900527 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineMA24007NEW JERSEYNo
2207RG0100XInternal MedicineGastroenterologyMA24007NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11415301MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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