| NPI | 1972617298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALDO A CICCOTELLI Physician/Business Owner 215-504-5253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MC542735C) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |