Provider Demographics
NPI:1295844702
Name:RICCIO, ALBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:H
Last Name:RICCIO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:45 RESEARCH WAY
Mailing Address - Street 2:SUITE 008 & 108
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6401
Mailing Address - Country:US
Mailing Address - Phone:631-941-2704
Mailing Address - Fax:631-941-2009
Practice Address - Street 1:45 RESEARCH WAY
Practice Address - Street 2:SUITE 008 & 108
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-6401
Practice Address - Country:US
Practice Address - Phone:631-941-2704
Practice Address - Fax:631-941-2009
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-02-10
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Provider Licenses
StateLicense IDTaxonomies
NY114506-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB80470Medicare UPIN
NY289311Medicare PIN
NY110038859Medicare PIN