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General NPI Number Information
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NPI Number | 1013977057
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Entity Type | Individual
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Provider Name | EILEEN MELLOR SICILIANO L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 50 AKERLY POND LN
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City | SOUTHOLD
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State | NY
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Zip | 11971-3005
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Country | US
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Telephone | 516-746-2972
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Fax |
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Provider Business Mailing Address
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Address Line | 10 OAK LN
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-2600
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Country | US
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Telephone | 516-746-2972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R053336-1
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License Number State | NY
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