Individual
MR. NATHAN A LARICCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-2733
(716) 845-2300
Mailing address
401 PICTURESQUE DR, ROCHESTER, NY 14616-1005
(585) 472-4387
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015563-1
NY
363AM0700X
Medical Physician Assistant
Primary
015563-1
NY
363AM0700X
Medical Physician Assistant
15563
NY
Other
Enumeration date
07/26/2012
Last updated
07/07/2023
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