Provider Demographics
NPI:1477545796
Name:SICAT, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:SICAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LITTLE CLOVE ROAD
Mailing Address - Street 2:MOUNT SINAI HEART
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301
Mailing Address - Country:US
Mailing Address - Phone:718-273-9080
Mailing Address - Fax:718-442-3784
Practice Address - Street 1:47 LITTLE CLOVE RD
Practice Address - Street 2:MOUNT SINAI HEART
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4306
Practice Address - Country:US
Practice Address - Phone:718-273-9080
Practice Address - Fax:718-442-3784
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210990207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02184343Medicaid
NY02184343Medicaid
NY409Q71Medicare ID - Type Unspecified