MEDICARE: MS. EILEEN MELLOR SICILIANO L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R053336-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P495339	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1013977057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EILEEN MELLOR SICILIANO L.C.S.W.

Provider Business Mailing Address
First Line	:	10 OAK LN
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2600
Country	:	US
Telephone Number	:	516-746-2972
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 AKERLY POND LN
Second Line	:
City	:	SOUTHOLD
State	:	NY
Zip	:	11971-3005
Country	:	US
Telephone Number	:	516-746-2972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	12/30/2025

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