Individual
MR. BLAIR LEE CICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
427 GUY PARK AVE, AMSTERDAM, NY 12010-1054
(518) 841-7237
Mailing address
427 GUY PARK AVE, AMSTERDAM, NY 12010-1054
(518) 841-7237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016862
NY
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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