# DR JOHN R CICERO SURGEON PODIATRIST INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629459219
- **Authorized official:** DR. JOHN R CICERO DPM (SURGEON PODIATRIST)
- **Authorized official phone:** (973) 338-3933

## Contact information

- **Practice address:** 10 MEADOW LN, BLOOMFIELD, NJ 07003-4308
- **Practice address phone:** (973) 338-3933
- **Practice address fax:** (973) 338-7969
- **Mailing address:** 10 MEADOW LN, BLOOMFIELD, NJ 07003-4308
- **Mailing address phone:** (973) 338-3933
- **Mailing address fax:** (973) 338-7969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 25MD00154100 | NJ | Yes |

## Other

- **Enumeration date:** 06/09/2015
- **Last updated:** 06/09/2015