Individual
MICHAEL P CICCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36 NEWARK AVE, SUITE 200 UROLOGY CONSULTANTS PA, BELLEVILLE, NJ 07109-4121
(973) 759-6950
(973) 759-6945
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA06919000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004065
—
NJ
Enumeration date
07/27/2006
Last updated
03/09/2022
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