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NPI Code Detail

MEDICARE: DR. PATRIZIA RICCARDI M.D.

MEDICARE: DR. PATRIZIA RICCARDI M.D.
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
12084P0800XPsychiatry Physician040697CT
22084P0800XPsychiatry Physician242224-01NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132936OTHERCTCONTROLLED SUBSTANCE

General Provider Information

NPI Number : 1598882086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRIZIA RICCARDI M.D.
Provider Business Mailing Address
First Line : 655 1ST ST
Second Line :
City : MACON
State : GA
Zip : 31201-2852
Country : US
Telephone Number : 478-301-2397
Fax Number :
Provider Business Practice Location Address
First Line : 1550 COLLEGE ST
Second Line :
City : MACON
State : GA
Zip : 31207-1500
Country : US
Telephone Number : 478-301-2397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 03/07/2023

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