Healthcare Provider Details

I. General information

NPI: 1023201845
Provider Name (Legal Business Name): ANN CHRISTINA CIANCONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MEDINA RD
AKRON OH
44333-2483
US

IV. Provider business mailing address

4125 MEDINA RD
AKRON OH
44333-2483
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-8168
  • Fax: 330-665-8087
Mailing address:
  • Phone: 330-665-8168
  • Fax: 330-665-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35-071181
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35071181
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: