Individual
MICHAEL S CICCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 COLLEGE PKWY, SUITE 100, WILLIAMSVILLE, NY 14221-6800
(434) 924-2047
Mailing address
100 COLLEGE PKWY, SUITE 100, WILLIAMSVILLE, NY 14221-6800
(716) 626-0093
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
251201
NY
390200000X
Student in an Organized Health Care Education/Training Program
0116017375
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03110469
—
NY
Enumeration date
05/02/2007
Last updated
09/24/2009
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