Healthcare Provider Details

I. General information

NPI: 1427981471
Provider Name (Legal Business Name): ELIZABETH CICILLINI MS, CDN, CSG, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S BROADWAY
YONKERS NY
10701-4006
US

IV. Provider business mailing address

115 OAKLAND AVE
TUCKAHOE NY
10707-1732
US

V. Phone/Fax

Practice location:
  • Phone: 914-378-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1101X
TaxonomyGerontological Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: