Provider Demographics
NPI:1609103928
Name:SICELOFF, BIRGIT ANNE (ANP)
Entity Type:Individual
Prefix:MISS
First Name:BIRGIT
Middle Name:ANNE
Last Name:SICELOFF
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 70TH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-9800
Mailing Address - Country:US
Mailing Address - Phone:212-746-2381
Mailing Address - Fax:
Practice Address - Street 1:520 EAST 70 TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-1409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303580363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health