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NPI Code Detail

MEDICARE: ERNEST J RICCO MD

MEDICARE: ERNEST J RICCO MD
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
1207L00000XAnesthesiology Physician047519LPA

General Provider Information

NPI Number : 1194716902
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNEST J RICCO MD
Provider Business Mailing Address
First Line : 804 SCOTT NIXON MEMORIAL DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30907-2464
Country : US
Telephone Number : 800-394-4445
Fax Number : 706-650-1034
Provider Business Practice Location Address
First Line : 800 SPRUCE ST
Second Line :
City : PHILA
State : PA
Zip : 19107-6130
Country : US
Telephone Number : 800-394-4445
Fax Number : 706-650-1034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2005
Last Update Date : 02/19/2015

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