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Individual

JARED J RICOTTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
271 RAILROAD ST, PHILIPSBURG, PA 16866-2300
(814) 342-1872
(814) 342-1874
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA055516
PA
363A00000X
Physician Assistant
Primary
OA002899
PA
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103109920
PA
Enumeration date
07/03/2012
Last updated
07/05/2021
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