Individual
ROBERT CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
4425 E COTTON CENTER BLVD, ALLRED COTTON CENTER, BUILDING 4, PHOENIX, AZ 85040-8854
(602) 452-9801
(602) 452-9852
Mailing address
4425 E COTTON CENTER BLVD, ALLRED COTTON CENTER, BUILDING 4, PHOENIX, AZ 85040-8854
(602) 452-9801
(602) 452-9852
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1323
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102559
—
AZ
Enumeration date
05/09/2006
Last updated
07/23/2007
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