Provider Demographics
NPI:1972617298
Name:BUCKS COUNTY FAMILY PRACTICE P.C.
Entity type:Organization
Organization Name:BUCKS COUNTY FAMILY PRACTICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CICCOTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-504-5253
Mailing Address - Street 1:106 CORPORATE DR E
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8005
Mailing Address - Country:US
Mailing Address - Phone:215-504-5253
Mailing Address - Fax:
Practice Address - Street 1:106 CORPORATE DR E
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8005
Practice Address - Country:US
Practice Address - Phone:215-504-5253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMC542735C207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063216Medicare ID - Type UnspecifiedMEDICARE ID#