Provider Demographics
NPI:1477204477
Name:SICA, STEVEN VINCENT (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:VINCENT
Last Name:SICA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 HUCKLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-4319
Mailing Address - Country:US
Mailing Address - Phone:860-329-1699
Mailing Address - Fax:
Practice Address - Street 1:789 HOWARD AVENUE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519
Practice Address - Country:US
Practice Address - Phone:203-688-9450
Practice Address - Fax:203-688-9065
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068277183500000X
CTPCT.0015272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist