Individual
MS. JEANINE SICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK ST # CB-2041, YNH MEDICAL SERVICES PC, NEW HAVEN, CT 06504-8900
(203) 688-4748
(203) 688-4740
Mailing address
20 YORK ST, CB-2041, NEW HAVEN, CT 06504-8900
(203) 688-4748
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001242
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001242
CT PA LICENSE NUMBER
CT
01
—
32678
CT CSR CERTIFICATE
CT
Enumeration date
10/05/2006
Last updated
03/07/2023
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