Provider Demographics
NPI:1265777528
Name:PICA, SHERYLANN E
Entity type:Individual
Prefix:MS
First Name:SHERYLANN
Middle Name:E
Last Name:PICA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 NEW NORWALK RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-4918
Mailing Address - Country:US
Mailing Address - Phone:203-912-8794
Mailing Address - Fax:
Practice Address - Street 1:494 ELM ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5115
Practice Address - Country:US
Practice Address - Phone:203-325-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001284224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant