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General NPI Number Information
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NPI Number | 1275457665
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Entity Type | Individual
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Provider Name | SASKA CICOVACKI
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Gender | Female
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 485 ROUTE 134
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3431
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Country | US
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Telephone | 508-394-0941
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Fax | 508-398-1403
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Provider Business Mailing Address
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Address Line | 68 LAKEWOOD DR
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City | HARWICH
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State | MA
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Zip | 02645-1816
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Country | US
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Telephone | 508-394-0941
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Fax | 508-398-1403
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL88570
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License Number State | MA
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