Provider Demographics
NPI:1821110420
Name:RICCIULLI, ANGELA TONI (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:TONI
Last Name:RICCIULLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 N CARNEGIE AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4128
Mailing Address - Country:US
Mailing Address - Phone:330-652-4978
Mailing Address - Fax:330-652-4994
Practice Address - Street 1:1250 YOUNGSTOWN WARREN RD BLDG 1
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4649
Practice Address - Country:US
Practice Address - Phone:330-652-4978
Practice Address - Fax:330-652-4994
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor