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NPI Code Detail

MEDICARE: DR. ANTONIO CICCONE DO

MEDICARE: DR. ANTONIO CICCONE DO
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
1207Q00000XFamily Medicine Physician25MB05752300NJ
2207P00000XEmergency Medicine Physician25MB05752300NJ
3207P00000XEmergency Medicine Physician210336NY
4207P00000XEmergency Medicine Physician032.0134276VT
5207P00000XEmergency Medicine Physician04283KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
231D0108390OTHERNJCLIA

General Provider Information

NPI Number : 1750413464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTONIO CICCONE DO
Provider Business Mailing Address
First Line : 25 RIDGEWOOD RD
Second Line :
City : SPRINGFIELD
State : VT
Zip : 05156-3057
Country : US
Telephone Number : 802-885-2151
Fax Number : 802-885-6964
Provider Business Practice Location Address
First Line : 727 JORALEMON ST
Second Line :
City : BELLEVILLE
State : NJ
Zip : 07109-1455
Country : US
Telephone Number : 973-751-2060
Fax Number : 973-751-2291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 02/04/2026

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Directions to “ DR. ANTONIO CICCONE DO” Practice Location

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