Provider Demographics
NPI:1972552230
Name:SICAT, JON F (DO)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:F
Last Name:SICAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1013 SHADOWLAWN DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1754
Mailing Address - Country:US
Mailing Address - Phone:973-926-4949
Mailing Address - Fax:973-923-8063
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-4949
Practice Address - Fax:973-923-8063
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB063641207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics