Individual
MISS AMY CICILY JOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3000
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
390200000X
NY
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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