Provider Demographics
NPI:1417281593
Name:CIOCI, LINDSEY JO (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:JO
Last Name:CIOCI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:STOTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:545 HOOKSETT RD UNIT 1
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2654
Practice Address - Country:US
Practice Address - Phone:603-255-4775
Practice Address - Fax:603-255-4776
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053870363A00000X
CAPA22940363A00000X
NC001001938363AM0700X
NH1816363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913155Medicaid
13155OtherBCBS
NC8913155Medicaid