Provider Demographics
NPI:1588619258
Name:CICERON, ASUNCION V (MD)
Entity Type:Individual
Prefix:DR
First Name:ASUNCION
Middle Name:V
Last Name:CICERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 SHORE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2642
Mailing Address - Country:US
Mailing Address - Phone:609-677-7211
Mailing Address - Fax:609-677-7210
Practice Address - Street 1:443 SHORE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2642
Practice Address - Country:US
Practice Address - Phone:609-677-7211
Practice Address - Fax:609-677-7210
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03865200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0551503Medicaid
NJ418521Medicare ID - Type Unspecified
NJ54188Medicare UPIN