Individual provider Active NPI

Anthony James Cicero, CDN

  • Registered Dietitian
  • Astoria, NY
National Provider Identifier
1073785804
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
004921 Issued in NY
Practice address
2534 Steinway St
Astoria, NY 11103-3702
Phone
(718) 777-5243
Fax
(718) 777-5250
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 004921 NY Primary

Addresses

Primary practice location

2534 Steinway St
Astoria, NY 11103-3702

Mailing address

14 Atmore PL
Staten Island, NY 10306-1161
Phone (718) 289-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1073785804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ATMORE PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061161",
            "telephone_number": "718-289-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033702",
            "telephone_number": "718-777-5243",
            "fax_number": "718-777-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICERO",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "CDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "004921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.