Individual
DR. ROBERT EDWARD CICCHINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
112 WALNUT AVE, SUITE A, WAYNESBURG, PA 15370-1668
(724) 627-5474
Mailing address
112 WALNUT AVE, SUITE A, WAYNESBURG, PA 15370-1668
(724) 627-5474
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS008378L
PA
208600000X
Surgery Physician
Primary
2222
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016433640004
—
PA
05
—
2723459
—
OH
05
—
3810008262
—
WV
05
—
412243700
—
MD
Enumeration date
11/03/2005
Last updated
04/07/2022
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