Individual
CARISSA CICCHINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 WALNUT ST STE 601, PHILADELPHIA, PA 19107-5563
(215) 955-3523
Mailing address
229 E FRONT ST, MEDIA, PA 19063-3035
(484) 226-6692
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD480664
PA
Other
Enumeration date
04/09/2020
Last updated
07/19/2023
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