Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 4754 | NY |
NPI | 1285740472 |
---|---|
Provider Name | Dr. Carol Ann Scicchitano |
First Address | Westbury, NY 11590-3248 |
Second Address | Westbury, NY 11590-3248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |