Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 260357 | NY |
NPI | 1255574844 |
---|---|
Provider Name | Mr. Benjamin Fox Ricciardi |
First Address | Rochester, NY 14620-2733 |
Second Address | Rochester, NY 14620-2733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2009 |
Last Update Date | 11/03/2017 |