Mark J Micciche is a Podiatrist in Scranton, Pennsylvania. Mark J Micciche practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Mark J Micciche is 1336195031. The last update date is 2020-08-21.
Mark J Micciche's current location address is 1800 Mulberry St, Scranton, Pennsylvania. You can contact this provider via phone number 5707038146 and fax number 5707037205. The mailing address for Mark J Micciche is 1800 Mulberry St, Scranton, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark J Micciche |
|---|---|
| Address | 1800 Mulberry St, Scranton, Pennsylvania |
| Phone Number | 5707038146 |
| Fax Number | 5707037205 |
| Sole Proprietor | N |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1336195031 |
|---|---|
| Provider Enumeration Date | 2006-05-25 |
| Last Updated Date | 2020-08-21 |
Provider Mailing Address Detail
| Address | 1800 Mulberry St |
|---|---|
| City | Scranton |
| State | Pennsylvania (PA) |
| Post Code | 185102369 |
| Phone Number | 5707038146 |
| Fax Number | 5707037205 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | SC-003638-L |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 15256920005 | PA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Mark J Micciche?
The Mark J Micciche has been issued the NPI (National Provider Identifier) 1336195031 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Mark J Micciche?
The Mark J Micciche is situated at 1800 Mulberry St, in the city of Scranton, state of PA, with the zip code 185102369.
What is Mark J Micciche's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mark J Micciche's area of specialization is Podiatrist, and the corresponding taxonomy code that categorizes this field of practice is 213E00000X.
On what date did the Mark J Micciche receive the assignment of its 1336195031 from the Centers for Medicare & Medicaid Services?
The Mark J Micciche was issued its 1336195031 by the Centers for Medicare & Medicaid Services on 2006-05-25.
As of what date was the information pertaining to Mark J Micciche, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Mark J Micciche, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-21.