Provider Demographics
NPI:1194975730
Name:RICCI, JOSEPH JOHN (MPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JOHN
Last Name:RICCI
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1402 INDUSTRIAL HIGHWAY
Mailing Address - Street 2:UNIT B
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1522
Mailing Address - Country:US
Mailing Address - Phone:484-472-6950
Mailing Address - Fax:484-472-6948
Practice Address - Street 1:1402 INDUSTRIAL HIGHWAY
Practice Address - Street 2:UNIT B
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1522
Practice Address - Country:US
Practice Address - Phone:484-472-6950
Practice Address - Fax:484-472-6948
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist