Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 205761 | NY |
NPI | 1356470785 |
---|---|
Provider Name | Dr. Maria Sheenna Sica |
First Address | Bay Shore, NY 11706-8408 |
Second Address | Bay Shore, NY 11706-8408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 07/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01876493 | (05) | NY |
G67214 | (02) |