Individual
DR. ANTONIO CICCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
727 JORALEMON ST, BELLEVILLE, NJ 07109-1455
(973) 751-2060
(973) 751-2291
Mailing address
25 RIDGEWOOD RD, SPRINGFIELD, VT 05156-3057
(802) 885-2151
(802) 885-6964
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
032.0134276
VT
207P00000X
Emergency Medicine Physician
04283
KY
207P00000X
Emergency Medicine Physician
210336
NY
207P00000X
Emergency Medicine Physician
25MB05752300
NJ
207Q00000X
Family Medicine Physician
25MB05752300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D0108390
CLIA
NJ
05
—
6163700
—
NJ
Enumeration date
03/09/2007
Last updated
02/04/2026
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