DR. JAMES E RICCELLI (NPI# 1760569644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760569644 |
| Entity Type | Individual |
| Full Name | DR. JAMES E RICCELLI |
| Other Name | MRS. LECIA M RICCELLI |
| Credential | DM |
| Practice Address |
5100 W Taft Rd Liverpool NY 13088-3807 |
| Mailing Address |
4560 Becker Rd Brewerton NY 13029-8700 |
| Practice Telephone | 3154522200 |
| Practice Fax Number | 3154522204 |
| Mailing Telephone | 3156763169 |
| Mailing Fax Number | 3156762574 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 1541 | NY | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417927682 | James P Riccelli | Specialist | 4939 Brittonfield Pkwy, E Syracuse, NY 13057-9208 | 2006-01-23 |
| 1649256157 | James Robert Riccelli | Military Health Care Provider | 2401 Hawkins Point Rd, Building 28b, Curtis Bay, MD 21226-1797 | 2005-12-16 |
| Street Address |
5100 W TAFT RD |
| City | LIVERPOOL |
| State | NY |
| Zip Code | 13088-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023015500 | Jody S Bleier | Internal Medicine | 5100 W Taft Rd, Suite 4j, Liverpool, NY 13088-3807 | 2005-06-30 |
| 1528620812 | Colleen Byrnes | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2019-07-08 |
| 1851866727 | Kathryn Quinn Manion | Clinic/Center | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-10-08 |
| 1225514623 | Shannon M Roach | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-07-18 |
| 1497263826 | Kimberly Cleary | Registered Nurse | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-01-19 |
| 1184077885 | Maia Czarnecki | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-07-18 |
| 1174974216 | Jenna Marie Laskey | Family Medicine | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2016-06-30 |
| 1669838108 | Phitsamai Thatvihane | Nurse Practitioner | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-01-14 |
| 1992160188 | Melissa Buttner | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-12-15 |
| 1538532940 | Chelsey Brooks | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-11-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878966 | Anthony Edward Blumetti | Psychologist | 5100 W. Taft Road, Suite 3b, Liverpool, NY 13088 | 2019-12-12 |
| 1609350016 | Alice Nellenbach | Physical Therapy Assistant | 346 Electronics Pkwy, Liverpool, NY 13088 | 2018-09-20 |
| 1043741457 | Dawn Marie Thomas | Licensed Practical Nurse | 212 Old Liverpool Road, Building 7 Apartment 6, Liverpool, NY 13088 | 2017-03-27 |
| 1154775633 | Arielle L Leonard | Massage Therapist | 609 7th N. Street, Suite 2, Liverpool, NY 13088 | 2016-04-20 |
| 1942664362 | Accessibility Solutions, Inc. | Contractor | 115 Luther Avenue, Liverpool, NY 13088 | 2016-04-12 |
| 1497176333 | Sergey Golovko | Psychiatry & Neurology | 125 Sun Harbor Dr, Liverpool, NY 13088 | 2013-12-19 |
| 1205275286 | Brandon William Crandall | Nurse Practitioner | 5100 West Taft Rd., Suite 1c, Liverpool, NY 13088 | 2013-06-23 |
| 1184976805 | Audrey Irene Tyszka | Social Worker | 5100 W Taft Rd Ste 1f, Liverpool, NY 13088 | 2012-10-04 |
| 1790049096 | Kelley Beth Burt | Speech-Language Pathologist | 110 Elwood Davis Road, Liverpool, NY 13088 | 2012-07-02 |
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104335371 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 497 Electronics Pkwy, Ep7, G200, Liverpool, NY 13088-6062 | 2017-09-20 |
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| 1922635218 | Proficient Rehab Care Pt Pllc | Clinic/Center | 121 Winham Ave, Staten Island, NY 10306-4930 | 2020-03-25 |
| 1104451525 | Dr Paul Poulakos Do, LLC | Clinic/Center | 186 9th Ave Apt 4f, New York, NY 10011-4918 | 2020-03-05 |
| 1538793732 | Yi Zhang Medical Wellness Pllc | Clinic/Center | 3815 Corporal Stone St Fl 2, Bayside, NY 11361-2140 | 2020-02-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.