Provider Demographics
NPI:1235558495
Name:SCARANO, CICILY (MSED)
Entity Type:Individual
Prefix:MRS
First Name:CICILY
Middle Name:
Last Name:SCARANO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:CICILY
Other - Middle Name:
Other - Last Name:BRICKHOUSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSED
Mailing Address - Street 1:1573 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3122
Mailing Address - Country:US
Mailing Address - Phone:646-836-2561
Mailing Address - Fax:
Practice Address - Street 1:8866 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7857
Practice Address - Country:US
Practice Address - Phone:718-850-0400
Practice Address - Fax:718-850-4441
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY817593141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist