Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD038799E | PA |
NPI | 1003818659 |
---|---|
Provider Name | Richard A Razzino |
First Address | Camp Hill, PA 17011-2205 |
Second Address | Camp Hill, PA 17011-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 23/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011552600003 | (05) | PA |
E58963 | (02) |