Individual
DR. ROBERT V RICCITELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
73 HIGH ST, CTN CHARLESTWON HEALTHCARE CENTER, CHARLESTOWN, MA 02129-3096
(617) 724-2270
(617) 724-2070
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-2270
(617) 724-2070
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2139
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362310
—
MA
01
—
403867
TUFTS HEALTH PLAN
MA
01
—
Y71098
BCBS MA
MA
Enumeration date
11/08/2005
Last updated
11/14/2012
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