Provider Demographics
NPI:1164454815
Name:CICIRELLO, FRANK C (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:C
Last Name:CICIRELLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2003
Mailing Address - Country:US
Mailing Address - Phone:412-828-0700
Mailing Address - Fax:412-828-9140
Practice Address - Street 1:609 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-2003
Practice Address - Country:US
Practice Address - Phone:412-828-0700
Practice Address - Fax:412-828-9140
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001862-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA037465OtherBLUE CROSS BLUE SHIELD #
PAAJ001862LOtherADJUNCTIVE PROCEDURE LICE
PADC001862LOtherCHIROPRACTIC LICENSE #
PA037465NS7Medicare ID - Type Unspecified
PADC001862LOtherCHIROPRACTIC LICENSE #