Provider Demographics
NPI:1720132277
Name:RECCHIA, STEVEN LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LOUIS
Last Name:RECCHIA
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 1:236 W 6TH ST
Mailing Address - Street 2:STE 407
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4532
Mailing Address - Country:US
Mailing Address - Phone:775-324-4545
Mailing Address - Fax:
Practice Address - Street 1:75 PRINGLE WAY STE 910
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8405
Practice Address - Country:US
Practice Address - Phone:775-324-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6532207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV6532OtherMEDICAL LICENSE
F35581Medicare UPIN