Provider Demographics
NPI:1720155203
Name:CECCONI, TERRIAN & DONOHUE, P.C.
Entity type:Organization
Organization Name:CECCONI, TERRIAN & DONOHUE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CECCONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-774-0330
Mailing Address - Street 1:1711 S STEPHENSON AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-3650
Mailing Address - Country:US
Mailing Address - Phone:906-774-0330
Mailing Address - Fax:906-774-2584
Practice Address - Street 1:1711 S STEPHENSON AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3650
Practice Address - Country:US
Practice Address - Phone:906-774-0330
Practice Address - Fax:906-774-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty