Provider Demographics
NPI:1326350661
Name:SIRICO, FILOMENA
Entity Type:Individual
Prefix:
First Name:FILOMENA
Middle Name:
Last Name:SIRICO
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 1:14 BLUE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8077
Mailing Address - Country:US
Mailing Address - Phone:732-252-5943
Mailing Address - Fax:
Practice Address - Street 1:14 BLUE RIDGE CT
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8077
Practice Address - Country:US
Practice Address - Phone:732-252-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist