Organization
LASERWAVE PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DA CICERO DPM (OWNER AND MEDICAL DIRECTOR)
(401) 363-3150
Entity
Organization
Contact information
Practice address
12 ROOSEVELT AVE STE 203, MYSTIC, CT 06355-2842
(401) 363-3150
Mailing address
12 ROOSEVELT AVE STE 203, MYSTIC, CT 06355-2842
(833) 527-3798
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
03/08/2023
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