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NPI Code Detail

MEDICARE: ANTHONY M RICCIARDI DPM

MEDICARE: ANTHONY M RICCIARDI DPM
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
1213E00000XPodiatrist9507NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1480022781OTHERNVRAILROAD MEDICARE

General Provider Information

NPI Number : 1629087242
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY M RICCIARDI DPM
Provider Business Mailing Address
First Line : 7135 W SAHARA AVE
Second Line : SUITE 201
City : LAS VEGAS
State : NV
Zip : 89117-2873
Country : US
Telephone Number : 702-878-2455
Fax Number : 702-878-4875
Provider Business Practice Location Address
First Line : 6120 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-6760
Country : US
Telephone Number : 702-213-9093
Fax Number : 702-483-6669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 06/12/2024

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Directions to “ ANTHONY M RICCIARDI DPM” Practice Location

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