Healthcare Provider Details

I. General information

NPI: 1417281593
Provider Name (Legal Business Name): LINDSEY JO CIOCI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY STOTLER PA-C

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 HOOKSETT RD UNIT 1
MANCHESTER NH
03104-2654
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 603-255-4775
  • Fax: 603-255-4776
Mailing address:
  • Phone: 603-410-6700
  • Fax: 603-319-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA053870
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA22940
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001001938
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1816
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: