Provider Demographics
NPI:1093954646
Name:RICCIO, ALEXANDRA P (NP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:P
Last Name:RICCIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4817
Mailing Address - Country:US
Mailing Address - Phone:603-225-2739
Mailing Address - Fax:603-228-6255
Practice Address - Street 1:38 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4817
Practice Address - Country:US
Practice Address - Phone:603-225-2739
Practice Address - Fax:603-228-6255
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH08118423363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology