Provider Demographics
NPI:1043574635
Name:CAIAZZO-SIKORSKI, KRISTINA
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:CAIAZZO-SIKORSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SOUTHERN LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1919
Mailing Address - Country:US
Mailing Address - Phone:845-544-2659
Mailing Address - Fax:
Practice Address - Street 1:51 SOUTHERN LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1919
Practice Address - Country:US
Practice Address - Phone:845-544-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2873346174400000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator