Individual provider · Type 1 NPI
Phillip Martin Cicco, N.P.
Nurse Practitioner · Syracuse, NY
Practice location
736 Irving Ave
Syracuse, NY 13210-1687
Mailing address
5046 Revolutionary Path
Liverpool, NY 13088
Other practice locations
- 50 Leroy St, Potsdam, NY 13676-1786 · (315) 265-3300
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 338748 (NY) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1679987143
Phillip Martin Cicco, N.P.'s National Provider Identifier is 1679987143, issued on Jun 12, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Syracuse, NY. The record was last updated on Jul 10, 2024.