Provider Demographics
NPI:1972497980
Name:CICCO, FELICIA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:MARIE
Last Name:CICCO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 LITTLE SPIKE WAY
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18504-1283
Mailing Address - Country:US
Mailing Address - Phone:570-909-7999
Mailing Address - Fax:
Practice Address - Street 1:3319 LAKE ARIEL HWY
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1174
Practice Address - Country:US
Practice Address - Phone:570-253-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program