Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1300X | Electrophysiology, Clinical | 009034-1 | NY |
NPI | 1417927682 |
---|---|
Provider Name | James P Riccelli |
First Address | E. Syracuse, NY 13057 |
Second Address | E Syracuse, NY 13057-9208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 06/12/2018 |