Individual
MR. BRENTON JOSEPH LARICCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
401 PICTURESQUE DR, ROCHESTER, NY 14616-1005
(585) 770-3642
Mailing address
401 PICTURESQUE DR, ROCHESTER, NY 14616-1005
(585) 770-3642
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
12642
NY
363A00000X
Physician Assistant
Primary
012642
NY
363AS0400X
Surgical Physician Assistant
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—
Other
Enumeration date
07/26/2008
Last updated
07/06/2023
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