Provider Demographics
NPI:1811644313
Name:CICCONE, ADRIANA LILY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LILY
Last Name:CICCONE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9669 SWEET APPLE LN NE
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6305
Mailing Address - Country:US
Mailing Address - Phone:412-726-3236
Mailing Address - Fax:
Practice Address - Street 1:8116 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6916
Practice Address - Country:US
Practice Address - Phone:443-261-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT7093225100000X
MD30322225100000X
NCP21046225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist