Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD039872E | PA |
NPI | 1831559814 |
---|---|
Provider Name | Roxanne Rick |
First Address | Monongahela, PA 15063-4549 |
Second Address | Monongahela, PA 15063-4549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2016 |
Last Update Date | 03/03/2016 |