Provider Demographics
NPI:1336480722
Name:RICCIARDI, DANIEL VINCENT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:VINCENT
Last Name:RICCIARDI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-3862
Mailing Address - Country:US
Mailing Address - Phone:716-648-2990
Mailing Address - Fax:716-648-6352
Practice Address - Street 1:358 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3862
Practice Address - Country:US
Practice Address - Phone:716-648-2990
Practice Address - Fax:716-648-6352
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI056896-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist