Provider Demographics
NPI:1588339071
Name:CIOCI, LUISA SUSAN (MD)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:SUSAN
Last Name:CIOCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROCKLEDGE AVE APT 611
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1216
Mailing Address - Country:US
Mailing Address - Phone:914-588-8133
Mailing Address - Fax:
Practice Address - Street 1:25 ROCKLEDGE AVE APT 611
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1216
Practice Address - Country:US
Practice Address - Phone:914-588-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275447207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology