Provider Demographics
NPI:1467413955
Name:MINELLA, RICCI A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICCI
Middle Name:A
Last Name:MINELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 CENTRE AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3721
Mailing Address - Country:US
Mailing Address - Phone:412-924-1100
Mailing Address - Fax:412-924-1111
Practice Address - Street 1:5750 CENTRE AVE STE 510
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3721
Practice Address - Country:US
Practice Address - Phone:412-924-1100
Practice Address - Fax:412-924-1111
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034510E174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010424350001Medicaid
PA060023880OtherRAILROAD MEDICARE
PA487608EDZMedicare ID - Type Unspecified
PA0010424350001Medicaid