Provider Demographics
NPI:1003874470
Name:RICCARDI, RICHARD R (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:RICCARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MERRIMACK ST
Mailing Address - Street 2:BLDG. 1
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1754
Mailing Address - Country:US
Mailing Address - Phone:978-687-2321
Mailing Address - Fax:978-685-7265
Practice Address - Street 1:260 MERRIMAC ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2192
Practice Address - Country:US
Practice Address - Phone:978-465-3033
Practice Address - Fax:978-685-7265
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227470207L00000X, 207LP2900X
NH13354207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2120097Medicaid
NH01Y010940MA02OtherANTHEM BCBSNH
NH30206072Medicaid
NH0039876OtherNEIGHBORHOOD HEALTH PLAN
1416266OtherAETNA
4786723OtherCIGNA
AA74844OtherHARVARD PILGRIM HEALTH CARE
495369OtherTUFTS HEALTH PLAN
MA96533502OtherNETWORK HEALTH
MAJ40323OtherBCBSMA
NH01Y010940MA02OtherANTHEM BCBSNH
495369OtherTUFTS HEALTH PLAN
NH30206072Medicaid