MICHAEL SAMUEL CICCHILLO (NPI# 1922033901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922033901 |
| Entity Type | Individual |
| Full Name | MICHAEL SAMUEL CICCHILLO |
| Credential | MD |
| Practice Address |
540 Parmalee Ave Ste 410 Youngstown OH 44510-1605 |
| Mailing Address |
540 Parmalee Ave Ste 410 Youngstown OH 44510-1605 |
| Practice Telephone | (330) 747-1106 |
| Practice Fax Number | 3307470491 |
| Mailing Telephone | (330) 747-1106 |
| Mailing Fax Number | 3307470491 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2017-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
35093033 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
540 PARMALEE AVE STE 410 |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44510-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497921597 | Robert D Burnside | Specialist/Technologist, Other | 540 Parmalee Ave Ste 410, Youngstown, OH 44510-1605 | 2008-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750889457 | Abolfazl Sodagar | Internal Medicine | 1001 Covington Street, Youngstown, OH 44510 | 2018-01-28 |
| 1285298422 | Kabir Kunwar | Internal Medicine | 1001 Covington Ave, Youngstown, OH 44510 | 2019-04-23 |
| 1861978603 | Fatemeh Dehghan Manshadi | Counselor | 611 Belmont Avenue, Youngstown, OH 44510 | 2018-07-16 |
| 1952780256 | Stephen Dominic Pupillo | Internal Medicine | 1001 Covington St, Youngstown, OH 44510 | 2015-05-20 |
| 1588005946 | Lisa J Cascarelli | Registered Nurse | 1001 Covington St, Youngstown, OH 44510 | 2013-07-15 |
| 1891041141 | Lillianne Stanitsas | Surgery | 1001 Covington St, Youngstown, OH 44510 | 2012-07-24 |
| 1356361075 | Fred R Pruitt | Internal Medicine | 550 Parmalee Ave, Suite 310, Youngstown, OH 44510 | 2006-07-19 |
| 1912900341 | Scientific Medical Imaging, Inc. | Specialist | 540 Parmalee Ave, Suite 100, Youngstown, OH 44510 | 2005-05-31 |
| 1972128130 | Destiny Frost | Home Health Aide | 2749 Hammaker St, Youngstown, OH 44510-1037 | 2020-06-13 |
| 1225638547 | Sharell Shanta Williams | Nurse's Aide | 1102 Norwood Ave, Youngstown, OH 44510-1104 | 2020-10-27 |
| Find all providers in zip 44510 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609195643 | Pratheek Simon Kakkasseril | Surgery | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2010-05-28 |
| 1467633149 | Mahoning Valley Wound Care, Inc. | Surgery | 540 Parmalee Ave, Suite 610, Youngstown, OH 44510-1716 | 2007-11-21 |
| 1497722375 | Venkata S. K. Kollipara | Surgery | 1001 Belmont Ave, Youngstown, OH 44504-1003 | 2006-03-01 |
| 1649247529 | Jason Richard Delatore | Surgery | 540 Parmalee Ave, 410, Youngstown, OH 44510-1716 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993459 | Matt Thompson | Surgery | Department of Vascular Surgery 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2020-05-14 |
| 1194373704 | Premier Vein and Vascular Care LLC | Surgery | 33290 Bainbridge Rd, Solon, OH 44139-2802 | 2019-08-27 |
| 1588144299 | Garcia Vascular Surgery Center, LLC | Surgery | 29099 Health Campus Dr Ste 380, Westlake, OH 44145-5276 | 2018-08-21 |
| 1962900365 | Marilyn Mcnamara | Surgery | 1031 Brook Ln, Rocky River, OH 44116-2184 | 2018-01-31 |
| 1386155521 | Zanesville Vascular Vein & Wound Center LLC | Surgery | 3964 Frazeysburg Rd Unit A, Zanesville, OH 43701-8920 | 2017-10-16 |
| 1679026751 | Center for Vein Restoration Oh, LLC | Surgery | 1050 Isaac Streets Dr Ste 131, Oregon, OH 43616-8203 | 2016-07-26 |
| 1235541640 | Jon Garrett Quatromoni | Surgery | Mail Code F30 9500 Euclid Avenue, Cleveland, OH 44195-4238 | 2014-05-20 |
| 1881035343 | Innovative Wound Care Associates, Inc | Surgery | 790 Boardman Canfield Rd Ste 3, Boardman, OH 44512-4344 | 2013-07-12 |
| 1184062242 | Jorge Enrique Motta | Surgery | 12268 Church Rd, Orrville, OH 44667-9623 | 2013-06-11 |
| 1912245853 | Cleveland East Vascular Care, LLC | Surgery | 23650 Commerce Park Ste B, Beachwood, OH 44122-5817 | 2013-01-28 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSTOWN |
| Zip Code | 44510 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.