Provider Demographics
NPI:1922008762
Name:PICI, MARIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 GRASSLANDS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1503
Mailing Address - Country:US
Mailing Address - Phone:914-304-5350
Mailing Address - Fax:914-345-1752
Practice Address - Street 1:503 GRASSLANDS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1503
Practice Address - Country:US
Practice Address - Phone:914-304-5350
Practice Address - Fax:914-345-1752
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148088208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00856708Medicaid
NYC07738Medicare UPIN
NY073Z70Medicare ID - Type Unspecified