Provider Demographics
NPI:1851325005
Name:CIRONE, MICHAEL (PA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:CIRONE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PARSONAGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2429
Mailing Address - Country:US
Mailing Address - Phone:732-662-4680
Mailing Address - Fax:
Practice Address - Street 1:10 PARSONAGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2429
Practice Address - Country:US
Practice Address - Phone:762-662-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00017300363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS29830Medicare UPIN
NJ059306MDSMedicare ID - Type Unspecified