Provider Demographics
NPI:1043338205
Name:ANTHONY RICCI P C
Entity Type:Organization
Organization Name:ANTHONY RICCI P C
Other - Org Name:ANNAPOLIS FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:RICCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-263-6331
Mailing Address - Street 1:1610 WEST ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4055
Mailing Address - Country:US
Mailing Address - Phone:410-263-6331
Mailing Address - Fax:410-280-9886
Practice Address - Street 1:1610 WEST ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4055
Practice Address - Country:US
Practice Address - Phone:410-263-6331
Practice Address - Fax:410-280-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1542 PT111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD293065600OtherUS DEPT LABOR PROV. ID
MD292468OtherALLIANCE PROVIDER ID
MD1623373OtherUHC PROVIDER ID
MD086650000OtherPREF HEALTH NET PROV. ID
MD6074299OtherCIGNA PROVIDER ID
MDLP84ANOtherCAREFIRST BCBS PROV. ID
MD5856209OtherAETNA PROVIDER ID
MDR6170002OtherFEDERAL BCBS PROV. ID
MDR6170002OtherFEDERAL BCBS PROV. ID
MDU27466Medicare UPIN
MD292468OtherALLIANCE PROVIDER ID
MD913L 355EMedicare ID - Type UnspecifiedMEDICARE PROVIDER ID