Healthcare Provider Details

I. General information

NPI: 1477545796
Provider Name (Legal Business Name): MICHAEL A SICAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 LITTLE CLOVE RD MOUNT SINAI HEART
STATEN ISLAND NY
10301-4306
US

IV. Provider business mailing address

47 LITTLE CLOVE ROAD MOUNT SINAI HEART
STATEN ISLAND NY
10301
US

V. Phone/Fax

Practice location:
  • Phone: 718-273-9080
  • Fax: 718-442-3784
Mailing address:
  • Phone: 718-273-9080
  • Fax: 718-442-3784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number210990
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: