Healthcare Provider Details

I. General information

NPI: 1649229550
Provider Name (Legal Business Name): CIPRIANO FAMILY PRACTICE, PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 DEKALB ST
NORRISTOWN PA
19401-3949
US

IV. Provider business mailing address

905 DEKALB ST
NORRISTOWN PA
19401-3949
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-1174
  • Fax: 610-277-4684
Mailing address:
  • Phone: 610-277-1174
  • Fax: 610-277-4684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS006832L
License Number StatePA

VIII. Authorized Official

Name: JOSEPH FRANCIS CIPRIANO
Title or Position: PHYSICIAN
Credential: DO
Phone: 610-277-1174