Doctor Name: | MICHAEL CICATELLI |
NPI Number: | 1871555003 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | O000020 |
Business Practice Address: | 11 Florence Rd Putnam Valley, NY - 105793423 |
Business Phone Number: | 8455281942 |
Business Fax Number: | 8455281942 |
Mailing Address: | 11 Florence Rd, PUTNAM VALLEY |
State: | NY |
Postal Code: | 105793423 |
Phone Number: | 8455281942 |
Fax Number: | 8455281942 |
NPI Enumeration Date: | 04/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | O000020 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |