Organization
CICCHIELLO CORPORATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN M CICCHIELLO PMHNP (EXECUTIVE DIRECTOR)
(570) 875-8058
Entity
Organization
Contact information
Practice address
601 W 5TH ST, MOUNT CARMEL, PA 17851-1803
(570) 875-8058
Mailing address
601 W 5TH ST, MOUNT CARMEL, PA 17851-1803
(570) 875-8058
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP009838
PA
364SA2200X
Adult Health Clinical Nurse Specialist
TP006931C
PA
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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