Healthcare Provider Details

I. General information

NPI: 1225232903
Provider Name (Legal Business Name): LAWRENCE PICCIONI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 BEISER BLVD SUITE 101
DOVER DE
19904
US

IV. Provider business mailing address

260 BEISER BLVD SUITE 101
DOVER DE
19904-7790
US

V. Phone/Fax

Practice location:
  • Phone: 302-730-8060
  • Fax: 302-730-8063
Mailing address:
  • Phone: 302-730-8060
  • Fax: 302-730-8063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC1-0003868
License Number StateDE

VIII. Authorized Official

Name: DR. LAWRENCE PICCIONI
Title or Position: PRESIDENT
Credential: MD
Phone: 302-730-8060