Healthcare Provider Details

I. General information

NPI: 1376405902
Provider Name (Legal Business Name): CARLO CICONE BIASI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51342 NATIONAL RD
SAINT CLAIRSVILLE OH
43950-1710
US

IV. Provider business mailing address

51342 NATIONAL RD
SAINT CLAIRSVILLE OH
43950-1710
US

V. Phone/Fax

Practice location:
  • Phone: 740-699-0940
  • Fax:
Mailing address:
  • Phone: 740-699-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number50.010012RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: