Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35081390 | OH |
NPI | 1003851833 |
---|---|
Provider Name | Dr. Daniel J Ricchiuti |
First Address | Boardman, OH 44512-5629 |
Second Address | Youngstown, OH 44510-1653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 14/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2612257 | (05) | OH |
I34567 | (02) | OH |