Healthcare Provider Details

I. General information

NPI: 1568603736
Provider Name (Legal Business Name): DOREEN A SICOTTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOREEN A BLANCO FNP

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MAIN ST SURGICAL SERVICES
MOUNT KISCO NY
10549-3417
US

IV. Provider business mailing address

NORTHERN WESTCHESTER HOSPITAL CENTER 400 E MAIN STREET MEDICAL AFFAIRS
MT KISCO NY
10549-3417
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-1344
  • Fax: 914-242-8192
Mailing address:
  • Phone: 914-242-8318
  • Fax: 914-666-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number333570
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: