Individual
JAN DECICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC A
Contact information
Practice address
44 ELM STREET, SUITE 4, HUNTINGTON, NY 11743-3403
(631) 271-6263
(631) 271-2062
Mailing address
44 ELM STREET, SUITE 4, HUNTINGTON, NY 11743-3403
(631) 271-6263
(631) 271-2062
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
0014801
NY
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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