Individual
DR. RICHARD W DICICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1 MYERS AVENUE, CEDAR BROOK, NJ 08018
(609) 561-1150
Mailing address
P.O. BOX 308, 1 MYERS AVE, CEDAR BROOK, NJ 08018
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00418400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0673372000
AMERIHEALTH
NJ
01
—
2230846
AETNA
NJ
Enumeration date
01/25/2007
Last updated
07/08/2007
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