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General NPI Number Information
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NPI Number | 1497076400
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Entity Type | Individual
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Provider Name | NINA J RICCI D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 256 MASON AVE # C
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3408
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Country | US
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Telephone | 718-226-6606
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Fax |
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Provider Business Mailing Address
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Address Line | 100 JAY ST APT 18H
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City | BROOKLYN
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State | NY
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Zip | 11201-1574
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Country | US
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Telephone | 716-713-2045
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 271184
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License Number State | NY
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