Healthcare Provider Details

I. General information

NPI: 1851027874
Provider Name (Legal Business Name): SHARON CICCOTOSTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12020 WEBSTER RD
STRONGSVILLE OH
44136-3722
US

IV. Provider business mailing address

12020 WEBSTER RD
STRONGSVILLE OH
44136-3722
US

V. Phone/Fax

Practice location:
  • Phone: 440-870-5139
  • Fax:
Mailing address:
  • Phone: 440-870-5139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: