Provider Demographics
NPI:1366462434
Name:CIKOWSKI, EDWARD C (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:CIKOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:965 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3997
Mailing Address - Country:US
Mailing Address - Phone:484-573-5116
Mailing Address - Fax:484-573-5122
Practice Address - Street 1:965 BALTIMORE PIKE
Practice Address - Street 2:SUITE 2B
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3997
Practice Address - Country:US
Practice Address - Phone:484-573-5116
Practice Address - Fax:484-573-5122
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2015-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007255L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA418742K6NMedicare PIN
PA418742HK1Medicare PIN