Provider Demographics
NPI:1396723979
Name:ORICOLI, BRIAN J (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:ORICOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:RIVER VALLEY CAMPUS
Practice Address - Street 2:2384 N. MEMORIAL DRIVE
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130
Practice Address - Country:US
Practice Address - Phone:749-689-4935
Practice Address - Fax:740-689-4889
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0769312081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH250013850OtherRAILROAD MEDICARE
OH9905329OtherCIGNA
OH311639119027OtherCARESOURCE MEDICIAD
OH7276417OtherAETNA
OH2344743Medicaid
OH2300720OtherUNITEDHEALTHCARE
OH000000234971OtherANTHEM BC/BS
OH9905329OtherCIGNA
OH7276417OtherAETNA
OH4087881Medicare PIN