Healthcare Provider Details

I. General information

NPI: 1497717763
Provider Name (Legal Business Name): JOCELYN SICAT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 HIGHLAND AVE
SALEM MA
01970-2738
US

IV. Provider business mailing address

72 HIGHLAND AVE
SALEM MA
01970-2738
US

V. Phone/Fax

Practice location:
  • Phone: 978-745-3050
  • Fax:
Mailing address:
  • Phone: 978-745-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number78092
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: