Provider Demographics
NPI:1912321282
Name:SICHERMAN, ROIZY
Entity Type:Individual
Prefix:MRS
First Name:ROIZY
Middle Name:
Last Name:SICHERMAN
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 1:4800 14TH AVE
Mailing Address - Street 2:APT #1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3148
Mailing Address - Country:US
Mailing Address - Phone:718-436-2460
Mailing Address - Fax:
Practice Address - Street 1:4800 14TH AVE
Practice Address - Street 2:APT #1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3148
Practice Address - Country:US
Practice Address - Phone:718-436-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist