Individual
MYRIAH SIRROCCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICIAD #
NY
01
—
1285628552
AGENCY NPI #
NY
01
—
WVE061
AGENCY MEDICARE #
NY
Enumeration date
09/08/2011
Last updated
11/07/2019
Update your record
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