Dr. Ethan Cicero, PHD, RN
Registered Nurse, General Practice in Watertown, Massachusetts
1639934789- Practice location
- 53 Carver RD, Watertown, MA 02472-1312
- Phone
- 561-703-0594
- Fax
- —
- Last updated
- February 3, 2025
Ethan Cicero is a Registered Nurse, General Practice based in Watertown, MA. Ethan Cicero practices in Watertown, MA and has the professional credentials of PHD, RN. The NPI Number for Ethan Cicero is 1639934789 and holds a License No. RN10003654 (MA). The current practice location address for Ethan Cicero is 53 Carver RD, Watertown, MA 02472-1312 and can be reached out via phone at 561-703-0594.
Provider Profile Details
- NPI Number
- 1639934789
- Provider Name
- Ethan Cicero
- Credential
- PHD, RN
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 53 Carver RD, Watertown, MA 02472-1312
- Phone Number
- 561-703-0594
- Primary Taxonomy
- Registered Nurse, General Practice · 163WG0000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- February 19, 2024
- Last Update Date
- February 3, 2025
- Certification Date
- February 3, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 53 Carver RD
Watertown, MA 02472-1312 - City
- Watertown
- State
- Massachusetts
- Zip
- 02472-1312
- Phone Number
- 561-703-0594
Provider Business Mailing Address Details
- Address
- 53 Carver RD
Watertown, MA 02472-1312 - City
- Watertown
- State
- MA
- Zip
- 02472-1312
- Phone Number
- 561-703-0594
License Information
- License Number
- RN10003654
- License State
- MA
- Taxonomy
- Registered Nurse, General Practice · 163WG0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Ethan Cicero, PHD, RN?
The NPI number of Dr. Ethan Cicero, PHD, RN is 1639934789. It was assigned on February 19, 2024 and is currently active in the NPPES registry.
What is the specialty of Dr. Ethan Cicero, PHD, RN?
Dr. Ethan Cicero, PHD, RN is registered under the primary taxonomy Registered Nurse, General Practice (code 163WG0000X), licensed in MA under license number RN10003654.
Where does Dr. Ethan Cicero, PHD, RN practice?
The practice location is 53 Carver RD, Watertown, MA 02472-1312. The office can be reached at 561-703-0594 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1639934789 directly on the NPPES registry website.