Healthcare Provider Details

I. General information

NPI: 1164901419
Provider Name (Legal Business Name): TROY CILONE LPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 MAIN ST
SHELBYVILLE KY
40065-1315
US

IV. Provider business mailing address

2621 DALE LN
FISHERVILLE KY
40023-6414
US

V. Phone/Fax

Practice location:
  • Phone: 502-647-2477
  • Fax:
Mailing address:
  • Phone: 502-379-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: