Organization
EUGENE CICCONE, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE M CICCONE MD (OWNER)
(860) 223-3331
Entity
Organization
Contact information
Practice address
279 NEW BRITAIN RD STE 10, KENSINGTON, CT 06037-3165
(860) 223-3331
(860) 225-2430
Mailing address
279 NEW BRITAIN RD STE 10, KENSINGTON, CT 06037-3165
(860) 223-3331
(860) 225-2430
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
030819
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001308198
—
CT
Enumeration date
11/27/2017
Last updated
11/27/2017
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