Organization
MARIDANIELLE D. ANNICCHIARICO, REGISTERED PHYSICIAN ASSISTANT-CERTIFIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIDANIELLE D. ANNICCHIARICO RPA-C (DIRECTOR)
(845) 566-4595
Entity
Organization
Contact information
Practice address
15 BLACK ANGUS CT, NEWBURGH, NY 12550-1567
(845) 566-4595
Mailing address
PO BOX 10082, NEWBURGH, NY 12552-0082
(845) 566-4595
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
005535-1
NY
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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