Healthcare Provider Details

I. General information

NPI: 1154614543
Provider Name (Legal Business Name): CENTER FOR THE HEALING ARTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 KINGS HIGHWAY EAST, SUITE 108 C/O WHOLE BODY MEDICINE
FAIRFIELD CT
06825
US

IV. Provider business mailing address

PO BOX 110172
TRUMBULL CT
06611-0172
US

V. Phone/Fax

Practice location:
  • Phone: 203-799-7733
  • Fax: 203-987-4853
Mailing address:
  • Phone: 203-799-7733
  • Fax: 203-987-4853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number026453
License Number StateCT

VIII. Authorized Official

Name: DR. ROBBAN ARIEL SICA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 203-799-7733