Provider Demographics
NPI:1578633814
Name:CIACCHELLA, SEBASTIAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:SEBASTIAN
Middle Name:J
Last Name:CIACCHELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-410-8300
Mailing Address - Fax:814-410-8331
Practice Address - Street 1:1450 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3374
Practice Address - Country:US
Practice Address - Phone:814-269-5200
Practice Address - Fax:814-269-5070
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4317162083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine