Individual
DOMINIC J RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 E LANCASTER AVE STE 275, WYNNEWOOD, PA 19096-3450
(610) 642-1908
(484) 476-2754
Mailing address
100 E LANCASTER AVE STE 275, WYNNEWOOD, PA 19096-3450
(610) 642-1908
(484) 476-2754
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA061938
PA
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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