Individual
ALYSE SICKLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
GAYLORD FARMS RD, WALLINGFORD, CT 06492
(203) 284-2800
(203) 679-3598
Mailing address
PO BOX 400, GAYLORD FARMS RD, WALLINGFORD, CT 06492-7048
(203) 284-2800
(203) 679-3598
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
032242
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1322429
—
CT
Enumeration date
11/09/2005
Last updated
05/29/2008
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