Edward J.P. Ciecko, DO, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EDWARD J.P. CIECKO, DO, PC

Practice address

12301 Medford Rd
Philadelphia, PA 19154-1924

Phone

(215) 632-7666

Fax

(215) 632-8116

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Edward J.P. Ciecko, D.O.

Title

Owner

Phone

(215) 632-7666

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356360564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BRIGGS RD",
            "address_2": "SUITE 210",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544100",
            "telephone_number": "856-231-4774",
            "fax_number": "856-231-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 MEDFORD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541924",
            "telephone_number": "215-632-7666",
            "fax_number": "215-632-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J.P. CIECKO, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CIECKO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J.P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-632-7666",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.