Healthcare Provider Details

I. General information

NPI: 1588619258
Provider Name (Legal Business Name): ASUNCION V CICERON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 SHORE RD SUITE 101
SOMERS POINT NJ
08244-2642
US

IV. Provider business mailing address

443 SHORE RD SUITE 101
SOMERS POINT NJ
08244-2642
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-7211
  • Fax: 609-677-7210
Mailing address:
  • Phone: 609-677-7211
  • Fax: 609-677-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA03865200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: