Individual provider · Type 1 NPI

Lidia Cicconetti, PA

Surgical Physician Assistant · Valley Stream, NY

NPI number 1629160866 Active

Practice location

900 Franklin Ave
Valley Stream, NY 11580-2145

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XPA9103231 (FL)
Surgical Physician Assistant Primary 363AS0400X008924 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1629160866

Lidia Cicconetti, PA's National Provider Identifier is 1629160866, issued on Sep 28, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Valley Stream, NY. The record was last updated on Nov 27, 2012.