Healthcare Provider Details

I. General information

NPI: 1639006851
Provider Name (Legal Business Name): JOSHUA CILLO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 MAIN ST STE 3
DICKSON CITY PA
18519-1368
US

IV. Provider business mailing address

1330 MAIN ST STE 3
DICKSON CITY PA
18519-1368
US

V. Phone/Fax

Practice location:
  • Phone: 570-489-9900
  • Fax: 570-489-4327
Mailing address:
  • Phone: 570-489-9900
  • Fax: 570-489-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA DAVID CILLO
Title or Position: OWNER
Credential: AU.D.
Phone: 570-489-9900