Individual
LAURA CICERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
998 CROOKED HILL RD, BLDG 47, BRENTWOOD, NY 11717-1019
(631) 761-2139
Mailing address
998 CROOKED HILL RD, BLDG 47, BRENTWOOD, NY 11717-1019
(631) 761-2139
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1578627785
NY
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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