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General NPI Number Information
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NPI Number | 1942602784
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Entity Type | Individual
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Provider Name | CHRISTY DANIELLE SICA I DA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 970 HOPE ST
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City | BRISTOL
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State | RI
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Zip | 02809-1224
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Country | US
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Telephone | 516-445-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 37 PROSPECT ST
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City | BRISTOL
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State | RI
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Zip | 02809-3134
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Country | US
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Telephone | 516-445-7740
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 00402
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License Number State | RI
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