Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 013198 | NY |
N | 103TC0700X | Clinical Psychologist | 013198 | NY |
N | 102L00000X | Psychologist | 013198 | NY |
N | 103T00000X | Psychologist | 013198 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 013198 | NY |
NPI | 1699981464 |
---|---|
Provider Name | Dr. Barbara Ann Cicero |
First Address | Elmhurst, NY 11373-4332 |
Second Address | Elmhurst, NY 11373-4332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |