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General NPI Number Information
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NPI Number | 1346446812
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Entity Type | Organization
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Legal Business Name | MARIO Q.RICCI M.D., P.C.
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 1254 CENTRAL PARK AVE
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City | YONKERS
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State | NY
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Zip | 10704-1059
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Country | US
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Telephone | 914-963-4936
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Fax | 914-964-8336
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Provider Business Mailing Address
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Address Line | 1254 CENTRAL PARK AVE
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City | YONKERS
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State | NY
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Zip | 10704-1059
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Country | US
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Telephone | 914-963-4936
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Fax | 914-964-8336
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MARIO Q RICCI SR.
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Credential | M.D.
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Telephone | 914-963-4936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 076517
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License Number State | NY
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