Individual
DR. GINO JOSEPH VRICELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV SURG UROLOGY PED, STE 2A, SAINT LOUIS, MO 63110-1002
(314) 454-6034
(314) 454-2876
Mailing address
660 S EUCLID AVE, MSC 8242-22-02, SAINT LOUIS, MO 63110-1010
(314) 362-8200
(314) 367-5016
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2013017657
MO
2088P0231X
Pediatric Urology Physician
2013017657
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200006355
—
MO
Enumeration date
06/13/2007
Last updated
11/15/2021
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