Ciccotelli, Gerald Angelo

Ciccotelli, Gerald Angelo is an sole proprietor health care provider with primary practice located at 4646 John R St , Detroit MI 48201-1916. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Nursing Service Providers / Emergency. Nursing Service Providers / General Practice is his primary health care specialty. Ciccotelli, Gerald Angelo can be contacted via phone (313) 576-1000.

Contact Information

Primary practice address
4646 John R St Detroit MI 48201-1916
Phone: (313) 576-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 4704187346 Michigan
Nursing Service Providers / Emergency 163WE0003X 4704187346 Michigan

Profile Details

NPI number 1689388282
LBN Legal business name Ciccotelli, Gerald Angelo
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2023
Last updated Jan 9th, 2023 - about 3 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689388282 NPPES
Michigan MEDICAID 23080

Popular Providers