Provider Demographics
NPI:1619869864
Name:AMICONE, ANTHONY FRANK
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:FRANK
Last Name:AMICONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-1150
Mailing Address - Country:US
Mailing Address - Phone:330-951-6118
Mailing Address - Fax:
Practice Address - Street 1:317 BROADVIEW AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44509-1150
Practice Address - Country:US
Practice Address - Phone:330-951-6118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X
OH201918601258171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171WH0202XOther Service ProvidersContractorHome Modifications