Healthcare Provider Details

I. General information

NPI: 1902409543
Provider Name (Legal Business Name): CZARMAINE ANDAYA CICCOTELLI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CZARMAINE DUNGO ANDAYA DPT

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FRANKLIN VILLAGE MALL
KITTANNING PA
16201-8803
US

IV. Provider business mailing address

2000 WESTINGHOUSE DR STE 200
CRANBERRY TWP PA
16066-5238
US

V. Phone/Fax

Practice location:
  • Phone: 724-543-6452
  • Fax:
Mailing address:
  • Phone: 724-343-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: