Healthcare Provider Details

I. General information

NPI: 1184083032
Provider Name (Legal Business Name): NICHOLAS PATRICK CIFERNO PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 NILES CORTLAND RD NE
WARREN OH
44484-1974
US

IV. Provider business mailing address

321 NILES CORTLAND RD NE
WARREN OH
44484-1974
US

V. Phone/Fax

Practice location:
  • Phone: 330-355-3234
  • Fax:
Mailing address:
  • Phone: 503-307-4428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: