Individual
DR. ANTHONY GUY MICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
183 ROUTE 206 SOUTH, FLANDERS, NJ 07836
(973) 347-3277
(973) 347-3141
Mailing address
402 LIPPINCOTT DR, MARLTON, NJ 08053-4112
(856) 782-3300
(856) 504-8029
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MA06222600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6564500
—
NJ
Enumeration date
06/07/2006
Last updated
05/26/2011
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