Provider Demographics
NPI:1457969966
Name:SICILIANO, FRANCESCO BALDASSARRE
Entity Type:Individual
Prefix:
First Name:FRANCESCO
Middle Name:BALDASSARRE
Last Name:SICILIANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 BAY RIDGE PKWY APT 43
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2706
Mailing Address - Country:US
Mailing Address - Phone:717-496-3467
Mailing Address - Fax:
Practice Address - Street 1:850 7TH AVE STE 706
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5438
Practice Address - Country:US
Practice Address - Phone:717-496-3467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP106104103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical