Individual
LOUIS J CICCOLELLO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 345-4000
Mailing address
6550 DELILAH RD STE 301, EGG HARBOR TWP, NJ 08234-5102
(609) 246-8184
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
50683
NJ
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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