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General NPI Number Information
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NPI Number | 1295003689
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Entity Type | Organization
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Legal Business Name | NIVEA BRIGGITTE CALICO, MD PLLC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 189 E 2ND ST
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City | NEW YORK
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State | NY
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Zip | 10009-7069
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Country | US
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Telephone | 347-218-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 189 E 2ND ST
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City | NEW YORK
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State | NY
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Zip | 10009-7069
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Country | US
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Telephone | 347-218-2908
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIVEA BRIGGITTE CALICO
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Credential | MD
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Telephone | 347-218-2908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 258021
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License Number State | NY
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