Provider Demographics
NPI:1225013659
Name:CICHON, ALFRED BERNARD (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:BERNARD
Last Name:CICHON
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Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:ONE WESTON CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5543
Mailing Address - Country:US
Mailing Address - Phone:207-623-5142
Mailing Address - Fax:207-623-5138
Practice Address - Street 1:1 WESTON CT
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5543
Practice Address - Country:US
Practice Address - Phone:207-623-5142
Practice Address - Fax:207-623-5142
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
ME248363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant