Provider Demographics
NPI:1447247622
Name:CIOCCA, JOSEPH J (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:CIOCCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SHARON RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-3148
Mailing Address - Country:US
Mailing Address - Phone:724-888-5040
Mailing Address - Fax:724-371-0911
Practice Address - Street 1:1200 SHARON RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-3148
Practice Address - Country:US
Practice Address - Phone:724-888-5040
Practice Address - Fax:724-371-0911
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062898L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016812020004Medicaid
PA0016812020004Medicaid
PAG78732Medicare UPIN