Dibacco, Richard D.
Dibacco, Richard D. is an sole proprietor health care provider with primary practice located at 4402 Peach St , Erie PA 16509-1358. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot Surgery is his primary health care specialty. Dibacco, Richard D. can be contacted via phone (814) 864-4874.Contact Information
Primary practice address
4402 Peach St
Erie PA 16509-1358
Phone: (814) 864-4874
Fax: (814) 864-4877
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | SC001282L | Pennsylvania |
Podiatric Medicine & Surgery Service Providers / Radiology | 213ER0200X | SC001282L | Pennsylvania |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | SC001282L | Pennsylvania |
Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | SC001282L | Pennsylvania |
Profile Details
NPI number | 1609849934 |
---|---|
LBN Legal business name | Dibacco, Richard D. |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 8th, 2006 |
Last updated | Jun 30th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609849934 | NPPES |
Pennsylvania | MEDICAID | 000501005-0001 |
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