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Individual

AUDRA P RICCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
485 HARTFORD RD, STE B, MANCHESTER, CT 06040-4869
(860) 646-1561
Mailing address
73 NEWTON RD, STE 101, PLAISTOW, NH 03865-2424
(978) 388-7272
(978) 388-7373

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005548
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004210457
CT
01
5511600
AETNA INDIV PIN
01
650001233
MEDICARE PTAN
CT
01
ANTHEM
080005548CT11
Enumeration date
07/13/2006
Last updated
12/28/2016
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