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1679987143
PHILLIP MARTIN CICCO
SYRACUSE, NY
NPI
1679987143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NY 338748)
Enumeration Date
2014-06-12
Last Update Date
2024-07-10
Business Address
PHILLIP MARTIN CICCO N.P.
736 IRVING AVE
SYRACUSE, NY 13210-1687
Phone number: 315-470-7111
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Mailing Address
PHILLIP MARTIN CICCO N.P.
5046 REVOLUTIONARY PATH
LIVERPOOL, NY 13088
Phone number: 570-498-7688
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