| David Cicione, | |
|
104 Metoxet St, Ridgway, PA 15853-1932 | |
| (814) 788-5534 | |
| (814) 788-5549 |
| Full Name | David Cicione |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 104 Metoxet St, Ridgway, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760859540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT018526 (Pennsylvania) | Primary |
| Provider Name | Elk Regional Professional Group, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1982668885 PECOS PAC ID: 4486553278 Enrollment ID: O20040423000700 |
| Mailing Address | Practice Location Address |
|---|---|
| David Cicione, 104 Metoxet St, Ridgway, PA 15853-1932 Ph: (814) 788-5534 | David Cicione, 104 Metoxet St, Ridgway, PA 15853-1932 Ph: (814) 788-5534 |
Gregory R. Petrosky Physical Therapist Medicare: Medicare Enrolled Practice Location: 1 South St, Ridgway, PA 15853 Phone: 814-772-7848 Fax: 814-772-7849 | |
Mr. Gregory Regis Petrosky, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 South St, Ridgway, PA 15853 Phone: 814-772-7848 Fax: 814-772-7849 | |
Mr. Andrew John Dornisch, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 104 Metoxet St, Ridgway, PA 15853 Phone: 814-788-5534 Fax: 814-788-5549 |