Individual
SANDRA LEIGH PICILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1267 57TH ST, BROOKLYN, NY 11219-4572
(718) 841-8000
(718) 838-3665
Mailing address
1267 57TH ST, BROOKLYN, NY 11219-4572
(718) 841-8000
(718) 838-3665
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
533234
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P40956897359602
DRIVERS LICENSE
NJ
Enumeration date
10/20/2017
Last updated
06/16/2018
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