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Individual

DR. RICHARD A CICCANTELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
158 MAIN ST, PENNSBURG, PA 18073
(215) 679-5393
(215) 679-9674
Mailing address
158 MAIN ST, UPPER PERKIOMEN PODIATRY, PENNSBURG, PA 18073
(215) 679-5393
(215) 679-9674

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC1300537002
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060564000
KEYSTONE
05
0800149
PA
01
1300597002
CIGNA
01
20008186
AMERIHEALTH
01
442480169
RAILROAD MEDICARE
01
50056654
CAPITAL BC
01
P2659559
OXFORD
Enumeration date
07/10/2006
Last updated
02/14/2013
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