Individual
JESSICA ANN LALICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
31 NEW DORP LN, STATEN ISLAND, NY 10306-2351
(718) 979-4466
Mailing address
93 MAINE AVE, STATEN ISLAND, NY 10314-2316
(917) 453-2368
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005576
NY
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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