Provider Demographics
NPI:1427034263
Name:SIKALIS, STEVEN (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SIKALIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 CHELMSFORD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-5149
Mailing Address - Country:US
Mailing Address - Phone:978-452-0127
Mailing Address - Fax:978-452-1749
Practice Address - Street 1:850 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-5149
Practice Address - Country:US
Practice Address - Phone:978-452-0127
Practice Address - Fax:978-452-1749
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0353639Medicaid
MAW15832OtherBLUE CROSS BLUE SHIELD
MA22-00463OtherUNITED HEALTHARE
MA725797OtherTUFTS
MA997540OtherNETWORK HEALTH
MA152048OtherHARVARD PILGRIM
MA0020543OtherNEIGHBORHOOD HEALTH PLAN
MA22-00081OtherEVERCARE
MA590587OtherAETNA
MAB20886201OtherCIGNA
MAB20886201OtherCIGNA
MAW85439Medicare UPIN