Provider Demographics
NPI:1427035088
Name:FICCHI, JOSEPH S (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:FICCHI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 NEW UTRECHT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7301 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5137
Practice Address - Country:US
Practice Address - Phone:718-236-0213
Practice Address - Fax:718-236-0217
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004085-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP43821Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
NYT51372Medicare UPIN
NY1021490001Medicare NSC