Provider Demographics
NPI:1528029006
Name:TRICARICO, JAMES ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:TRICARICO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:457 NORTH MAIN ST
Mailing Address - Street 2:STE 105
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2185
Mailing Address - Country:US
Mailing Address - Phone:570-883-9444
Mailing Address - Fax:570-883-9333
Practice Address - Street 1:499 WYOMING AVE STE 105
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3602
Practice Address - Country:US
Practice Address - Phone:570-714-3050
Practice Address - Fax:570-714-3055
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010594L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002573OtherUNITED HEALTHCARE
PA60253 E180OtherGEISINGER HEALTH
PA001863297001Medicaid
PA1307341OtherFIRST PRIORITY LIFE
PA002627OtherFIRST PRIORITY HEALTH
PA60253 E180OtherGEISINGER GOLD
PA002627OtherFIRST PRIORITY HEALTH CAP
PA080176555OtherRAILROAD MEDICARE
PA60253OtherGEISINGER CAPITATION
PA002573OtherAETNA
PA047917OtherMEDICARE-MLRM
PA1307341OtherPA BLUE SHIELD
PA010122600OtherFEDERAL BLACK LUNG
PA2000683000OtherPA BS PERSONAL CHOICE
PA249865OtherPHS
PA002627OtherFIRST PRIORITY HEALTH