Individual
DR. CARMINE CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 HAZARD AVE, SUITE 101, ENFIELD, CT 06082-4520
(860) 272-2940
(860) 272-2941
Mailing address
140 HAZARD AVE, SUITE 101, ENFIELD, CT 06082-4520
(860) 272-2940
(860) 272-2941
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
029420
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001294206
—
CT
Enumeration date
11/07/2005
Last updated
11/16/2016
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