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NPI Code Detail

MEDICARE: NICOLE CIFRA

MEDICARE:   NICOLE  CIFRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianMD477924PA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1386098929
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CIFRA
Provider Business Mailing Address
First Line : 3501 CIVIC CENTER BOULEVARD
Second Line : HUB, FL 14, ROOM 14585
City : PHILADELPHIA
State : PA
Zip : 19104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3501 CIVIC CENTER BLVD FL 14
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3820
Country : US
Telephone Number : 215-590-3537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2016
Last Update Date : 07/14/2022

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Directions to “ NICOLE CIFRA ” Practice Location

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