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General NPI Number Information
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NPI Number | 1699773663
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Entity Type | Individual
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Provider Name | JEFFREY S CICONE MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 1092 OLD CHURCHMANS RD
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City | NEWARK
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State | DE
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Zip | 19713-2102
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Country | US
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Telephone | 302-472-9880
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Fax | 302-472-9614
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Provider Business Mailing Address
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Address Line | 4923 OGLETOWN STANTON RD SUITE 200
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City | NEWARK
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State | DE
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Zip | 19713-2081
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Country | US
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Telephone | 302-225-0451
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Fax | 302-225-0470
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D0057385
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | C10005608
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License Number State | DE
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