Individual
MRS. TANYA CICERALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
355 GRAND STREET, JERSEY CITY, NJ 07302
(201) 915-2467
(732) 923-2272
Mailing address
379 CAMPUS DR FL 4, SOMERSET, NJ 08873-1161
(732) 937-8939
(732) 418-8372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00144300
NJ
363AS0400X
Surgical Physician Assistant
25MP00144300
NJ
Other
Enumeration date
04/23/2007
Last updated
08/01/2024
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