Individual
LUIS EDUARDO CICONINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 CLARKSON AVENUE, NEW YORK CITY, NY 11203-2098
(718) 270-1926
Mailing address
450 CLARKSON AVENUE, BOX 1229, NEW YORK CITY, NY 11203-2098
(718) 270-1926
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-165475
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2022
Last updated
05/04/2026
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