Provider Demographics
NPI:1407848674
Name:CINICOLA, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:CINICOLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:409 SOUTH SECOND STREET
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-231-8508
Mailing Address - Fax:717-231-8535
Practice Address - Street 1:205 S FRONT ST STE 3C
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8532
Practice Address - Fax:717-231-8535
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD041470L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001208470Medicaid
PAP00227049Medicare PIN
PAE65429Medicare UPIN
PA612994NJKMedicare PIN