Provider Demographics
NPI:1528033511
Name:RICKIN, ERIC DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:RICKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 OLD FREEPORT RD STE 1AF
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3115
Mailing Address - Country:US
Mailing Address - Phone:412-407-7876
Mailing Address - Fax:918-398-9125
Practice Address - Street 1:1386 OLD FREEPORT RD STE 1AF
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3115
Practice Address - Country:US
Practice Address - Phone:412-407-7876
Practice Address - Fax:918-398-9125
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419527174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101375417Medicaid
PA092957F3FMedicare ID - Type Unspecified
PA101375417Medicaid