Provider Demographics
NPI:1295003689
Name:NIVEA BRIGGITTE CALICO, MD PLLC
Entity Type:Organization
Organization Name:NIVEA BRIGGITTE CALICO, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIVEA
Authorized Official - Middle Name:BRIGGITTE
Authorized Official - Last Name:CALICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-218-2908
Mailing Address - Street 1:189 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7069
Mailing Address - Country:US
Mailing Address - Phone:347-218-2908
Mailing Address - Fax:
Practice Address - Street 1:189 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7069
Practice Address - Country:US
Practice Address - Phone:347-218-2908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2580212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty