Healthcare Provider Details

I. General information

NPI: 1265344832
Provider Name (Legal Business Name): ANDREA SIKAVI MA/ CAGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 GOTHAM AVE
ELMONT NY
11003-2131
US

IV. Provider business mailing address

147 SALEM RD
ROSLYN HEIGHTS NY
11577-1518
US

V. Phone/Fax

Practice location:
  • Phone: 516-761-4976
  • Fax:
Mailing address:
  • Phone: 516-761-4976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1854040241
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: