Provider Demographics
NPI:1982291811
Name:RICCIO, ADRIANNA MARIE
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:MARIE
Last Name:RICCIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 GEORGE WASHINGTON HWY STE 302
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4211
Mailing Address - Country:US
Mailing Address - Phone:401-334-0754
Mailing Address - Fax:401-334-5024
Practice Address - Street 1:622 GEORGE WASHINGTON HWY STE 302
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4211
Practice Address - Country:US
Practice Address - Phone:401-334-0754
Practice Address - Fax:401-334-5024
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH06056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist