Individual
LAWRENCE R RICCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 BISHOP ST, PORTLAND, ME 04103-2659
(207) 871-1235
(207) 871-6161
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10718
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30788099
—
ME
01
—
RB7
ANTHEM
ME
Enumeration date
11/08/2006
Last updated
07/09/2007
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