Provider Demographics
NPI:1891117834
Name:RICCHI, DARREN (BC-HIS)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:RICCHI
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4723
Mailing Address - Country:US
Mailing Address - Phone:413-442-0593
Mailing Address - Fax:413-442-0593
Practice Address - Street 1:169 1ST ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4723
Practice Address - Country:US
Practice Address - Phone:413-442-0593
Practice Address - Fax:413-442-0596
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1598891855Medicaid