Individual
MR. MICHAEL LOUIS SCICCHITANO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3 COLGATE STREET, PORT JEFFERSON STATION, NY 11776
(631) 457-9158
Mailing address
3 COLGATE ST, PORT JEFFERSON STATION, NY 11776-2803
(631) 457-9158
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
019032
NY
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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