MEDICARE: JOANN RICHICHI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MB046837	NJ

General Provider Information

NPI Number	:	1023088390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN RICHICHI D.O.

Provider Business Mailing Address
First Line	:	PO BOX 536
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-0536
Country	:	US
Telephone Number	:	856-669-6050
Fax Number	:	856-651-0794

Provider Business Practice Location Address
First Line	:	239 HURFFVILLE CROSSKEYS RD
Second Line	:	STE 250
City	:	SEWELL
State	:	NJ
Zip	:	08080-4002
Country	:	US
Telephone Number	:	856-262-8300
Fax Number	:	856-262-1635

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/21/2011

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