Provider Demographics
NPI:1003986225
Name:RICCIARDI'S SHOES
Entity Type:Organization
Organization Name:RICCIARDI'S SHOES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:RICCIARDI
Authorized Official - Suffix:SR
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:412-885-2586
Mailing Address - Street 1:1900 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-4202
Mailing Address - Country:US
Mailing Address - Phone:412-885-2586
Mailing Address - Fax:412-885-2597
Practice Address - Street 1:1900 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-4202
Practice Address - Country:US
Practice Address - Phone:412-885-2586
Practice Address - Fax:412-885-2597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0738800002OtherDURABLE EQUIPMENT