Individual
LISA L. RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
325 PARK AVE, HUNTINGTON, NY 11743-2779
(631) 351-3722
(631) 385-1046
Mailing address
325 PARK AVE, HUNTINGTON, NY 11743-2779
(631) 351-3722
(631) 385-1046
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005238-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2C5927
HEALTHNET
NY
01
—
6201199
GHI
NY
01
—
P1072042
OXFORD
NY
01
—
PA7731
BLUE CROSS/ BLUE SHIELD
NY
Enumeration date
08/15/2006
Last updated
07/09/2008
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