Provider Demographics
NPI:1912180928
Name:SICILIANO, LESLIE A (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:A
Last Name:SICILIANO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 OSGOOD ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5411
Mailing Address - Country:US
Mailing Address - Phone:978-475-3806
Mailing Address - Fax:
Practice Address - Street 1:32 OSGOOD ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-5411
Practice Address - Country:US
Practice Address - Phone:978-475-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist