Healthcare Provider Details

I. General information

NPI: 1104669456
Provider Name (Legal Business Name): CYTOHEAL WOUND SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 PEMBROKE ST
PEMBROKE NH
03275-3235
US

IV. Provider business mailing address

37 LAKEWOOD DR
TRUMBULL CT
06611-2446
US

V. Phone/Fax

Practice location:
  • Phone: 603-824-5009
  • Fax:
Mailing address:
  • Phone: 203-605-1452
  • Fax: 885-921-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBBAN ARIEL SICA
Title or Position: OWNER
Credential: MD
Phone: 203-799-7733