Provider Demographics
NPI:1700315942
Name:RALPH DOBKIN, LARIENA NICOLE (RN)
Entity type:Individual
Prefix:
First Name:LARIENA
Middle Name:NICOLE
Last Name:RALPH DOBKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LARIENA
Other - Middle Name:NICOLE
Other - Last Name:RALPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:GATES BUILDING 10TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2826
Mailing Address - Fax:215-662-2434
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:GATES BUILDING 10TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4222
Practice Address - Country:US
Practice Address - Phone:215-662-2826
Practice Address - Fax:215-662-2434
Is Sole Proprietor?:No
Enumeration Date:2017-06-10
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN633023363LP0808X
MARN2271931163WM0102X, 163WP0807X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent