Healthcare Provider Details

I. General information

NPI: 1457000143
Provider Name (Legal Business Name): RICHARD TRICARDO MD, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 STEARNS LN
DANVILLE PA
17821-8850
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6516
  • Fax: 570-271-5814
Mailing address:
  • Phone: 570-271-6516
  • Fax: 570-271-5814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD494938
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number103273
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: