Provider Demographics
NPI:1902409543
Name:CICCOTELLI, CZARMAINE ANDAYA (DPT)
Entity type:Individual
Prefix:
First Name:CZARMAINE
Middle Name:ANDAYA
Last Name:CICCOTELLI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CZARMAINE
Other - Middle Name:DUNGO
Other - Last Name:ANDAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2000 WESTINGHOUSE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5238
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:
Practice Address - Street 1:5 FRANKLIN VILLAGE MALL
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-8803
Practice Address - Country:US
Practice Address - Phone:724-543-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist