| Doctor Name: | DR. MARLYN V MILICIA |
| NPI Number: | 1821096249 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | 6016-1 |
| Business Practice Address: | 7905 Main Rd Mattituck, NY - 11766 |
| Business Phone Number: | 6312442930 |
| Business Fax Number: | 6316512794 |
| Mailing Address: | 9 Savanna Circle, MOUNT SINAI |
| State: | NY |
| Postal Code: | 11766 |
| Phone Number: | 6312442930 |
| Fax Number: | 6312442930 |
| NPI Enumeration Date: | 07/09/2005 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 6016-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |