Individual
DENNIS B CICCHINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2 EMPIRE DR, RENSSELAER, NY 12144-5730
(518) 286-4899
(518) 286-4859
Mailing address
PO BOX 689, TROY, NY 12181-0689
(518) 268-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000480
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01819910
—
NY
Enumeration date
03/28/2006
Last updated
05/09/2008
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