Provider Demographics
NPI:1881612422
Name:RICCI, WILLIAM MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:RICCI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:ATTENTION: WILLIAM RICCI, MD
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4823
Mailing Address - Country:US
Mailing Address - Phone:212-606-1206
Mailing Address - Fax:917-260-3026
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:ATTENTION: WILLIAM RICCI, MD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4823
Practice Address - Country:US
Practice Address - Phone:212-606-1206
Practice Address - Fax:917-260-3026
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO115144207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203755707Medicaid
MO200034320Medicare PIN
MO079010232Medicare PIN
IL$$$$$$$$$Medicaid