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NPI Code Detail

MEDICARE: DR. ROSEANNE MARGUERITE RICCIARDI O.D.

MEDICARE:  DR. ROSEANNE MARGUERITE RICCIARDI  O.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
1152W00000XOptometristTUV004325-1NY

General Provider Information

NPI Number : 1881740082
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSEANNE MARGUERITE RICCIARDI O.D.
Provider Business Mailing Address
First Line : 8421 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4601
Country : US
Telephone Number : 718-491-2300
Fax Number : 718-491-2298
Provider Business Practice Location Address
First Line : 8421 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4601
Country : US
Telephone Number : 718-491-2300
Fax Number : 718-491-2298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2007
Last Update Date : 07/09/2007

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Directions to “ DR. ROSEANNE MARGUERITE RICCIARDI O.D.” Practice Location

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