Cicerone, Keith D
Cicerone, Keith D is an sole proprietor health care provider with primary practice located at 2048 Oak Tree Rd , Edison NJ 08820-2012. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Cicerone, Keith D can be contacted via phone (732) 906-2645.Contact Information
Primary practice address
2048 Oak Tree Rd
Edison NJ 08820-2012
Phone: (732) 906-2645
Fax: (732) 906-9241
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 35SI00213000 | New Jersey |
Profile Details
| NPI number | 1891877528 |
|---|---|
| LBN Legal business name | Cicerone, Keith D |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891877528 | NPPES |
| New Jersey | MEDICAID | 6740502 |
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