Provider Demographics
NPI:1598853996
Name:CIMINO, ERNEST JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:JOHN
Last Name:CIMINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1666 EDGEWOOD RD
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5547
Mailing Address - Country:US
Mailing Address - Phone:215-493-2231
Mailing Address - Fax:215-493-7454
Practice Address - Street 1:1666 EDGEWOOD RD
Practice Address - Street 2:BUILDING 2
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5547
Practice Address - Country:US
Practice Address - Phone:215-493-2231
Practice Address - Fax:215-493-7454
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA053619208200000X
PAMD044017-E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE21990Medicare UPIN
PACI487013Medicare ID - Type Unspecified