Individual
DR. LEE MICHAEL CICCARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
429 WASHINGTON BLVD, WILLIAMSPORT, PA 17701-5255
(570) 327-9480
(570) 327-9483
Mailing address
429 WASHINGTON BLVD, WILLIAMSPORT, PA 17701-5255
(570) 327-9480
(570) 327-9483
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
MD022616E
PA
174400000X
Specialist
Primary
MD022616E
PA
Other
Enumeration date
05/16/2006
Last updated
01/04/2021
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