Provider Demographics
NPI:1548292154
Name:CICIRELLO, KATHERINE PALOMBINI (DC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:PALOMBINI
Last Name:CICIRELLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:PALOMBINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2003
Mailing Address - Country:US
Mailing Address - Phone:412-828-0700
Mailing Address - Fax:412-828-9140
Practice Address - Street 1:609 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-2003
Practice Address - Country:US
Practice Address - Phone:412-828-0700
Practice Address - Fax:412-828-9140
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-001863-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADC-001863-LOtherCHIROPRACTIC LICENSE
PAAJ-001863-LOtherADJUNCTIVE PROCEDURE LIC
PAAJ-001863-LOtherADJUNCTIVE PROCEDURE LIC
PAT72391Medicare UPIN