Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 256417 | NY |
NPI | 1083758346 |
---|---|
Provider Name | Julie Elizabeth Riccio |
First Address | Syracuse, NY 13210-3417 |
Second Address | Rochester, NY 14642-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 17/09/2019 |