Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 25MA089624500 | NJ |
Y | 2084N0402X | Child Neurologist | 264737-1 | NY |
N | 2084N0600X | Clinical Neurophysiologist | 25MA089624500 | NJ |
NPI | 1245226059 |
---|---|
Provider Name | Juliann Marie Paolicchi |
First Address | N White Plains, NY 10603-2417 |
Second Address | Hackensack, NJ 07601-1997 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 08/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0090688000 | (05) | WV |
03450699 | (05) | NY |
0449423 | (05) | NJ |
2021985 | (05) | OH |
64955990 | (05) | KY |
G66591 | (02) |