Active NPI
Edmund Leigh Riccio, PSYD
- Clinical Psychologist
- Villanova, PA
National Provider Identifier
1497102438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017534
- Practice address
- 800 E Lancaster Ave
Villanova, PA 19085-1603 - Phone
- (610) 248-7465
- NPI assigned
- May 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS017534 | PA | Primary |
Addresses
Primary practice location
800 E Lancaster Ave
Villanova, PA 19085-1603
Mailing address
632 Edinburgh Dr
West Chester, PA 19382-7912
Phone (610) 248-7465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS017534 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1497102438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 EDINBURGH DR",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193827912",
"telephone_number": "610-248-7465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E LANCASTER AVE",
"city": "VILLANOVA",
"state": "PA",
"postal_code": "190851603",
"telephone_number": "610-248-7465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCIO",
"first_name": "EDMUND",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villanova, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.