LIDIA CICCONETTI PA NPI 1629160866

NPI Information

  • NPI: 1629160866
  • Provider Name: LIDIA CICCONETTI, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 900 FRANKLIN AVE
    VALLEY STREAM, NY
    ZIP 11580
  • Phone: (516) 256-6000

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NPI Details

Lidia Cicconetti, PA is a surgical physician assistant in Valley Stream, NY with 24 years of experience. Lidia Cicconetti, PA NPI is 1629160866. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

900 FRANKLIN AVE
VALLEY STREAM, NY
ZIP 11580-145
Phone: (516) 256-6000

The NPI 1629160866 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/28/2006 and was last updated on 11/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalPA9103231FLORIDANo
2363AS0400XPhysician AssistantSurgical008924NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001320600MEDICAIDFLORIDA
2008924OTHERNEW YORKLICENSE
3P80695MEDICARE UPIN
4U6059YMEDICARE PINFLORIDA
5PA9103231OTHERFLORIDALICENSE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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