Provider Demographics
NPI:1275145518
Name:CICHELLI, RONAN
Entity Type:Individual
Prefix:
First Name:RONAN
Middle Name:
Last Name:CICHELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-2474
Mailing Address - Country:US
Mailing Address - Phone:775-463-6597
Mailing Address - Fax:
Practice Address - Street 1:3595 US HIGHWAY 50 UNIT 5
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429-7399
Practice Address - Country:US
Practice Address - Phone:775-577-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist