Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 118172 | NY |
NPI | 1043316342 |
---|---|
Provider Name | Dr. Joseph James Tricarico |
First Address | Brooklyn, NY 11209-3206 |
Second Address | Brooklyn, NY 11209-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 23/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01637943 | (05) | NY |
694611 | BLUE CROSS BLUE SHEILD (01) | NY |
A63858 | (02) | NY |
CG6061 | MEDICARE RR (01) | NY |