Provider Demographics
NPI:1538238530
Name:CICIPPIO, THOMAS JOHN III (DPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:CICIPPIO
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1930
Mailing Address - Country:US
Mailing Address - Phone:610-277-2734
Mailing Address - Fax:
Practice Address - Street 1:3201 CHELTENHAM AVENUE
Practice Address - Street 2:SUITE 207
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095
Practice Address - Country:US
Practice Address - Phone:215-517-7551
Practice Address - Fax:215-517-7549
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist