Individual
RICHARD PANICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
80 LANDINGS DRIVE, SUITE 205, WASHINGTON, PA 15301-9408
(724) 941-3020
Mailing address
80 LANDINGS DRIVE, SUITE 205, WASHINGTON, PA 15301-9408
(724) 941-3020
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS003143L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000680102004
—
PA
01
—
108119
BLUE CROSS
PA
Enumeration date
04/05/2006
Last updated
02/23/2015
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