MEDICARE: DR. ANTHONY N RICCI 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
1	204R00000X	Electrodiagnostic Medicine Physician	MD057871L	PA
2	208100000X	Physical Medicine & Rehabilitation Physician	MD057871L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922004746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY N RICCI M.D.

Provider Business Mailing Address
First Line	:	2000 WATERDAM PLAZA DR STE 140
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-5411
Country	:	US
Telephone Number	:	724-678-0282
Fax Number	:	724-260-5169

Provider Business Practice Location Address
First Line	:	2000 WATERDAM PLAZA DR STE 140
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-5411
Country	:	US
Telephone Number	:	724-678-0282
Fax Number	:	724-260-5169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	12/05/2022

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