Healthcare Provider Details

I. General information

NPI: 1366420598
Provider Name (Legal Business Name): ROBERT BENJAMIN SICA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 STATE ROUTE 66 STE 331
TINTON FALLS NJ
07753-7300
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 732-988-3441
  • Fax: 732-988-7123
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35SI00151900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: