Individual
KATY TICONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 DEKALB AVE # 19C, BROOKLYN, NY 11201-5425
(718) 250-6946
(718) 250-8120
Mailing address
121 DEKALB AVE # 19C, BROOKLYN, NY 11201-5425
(718) 250-6946
(718) 250-8120
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
29691
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2015
Last updated
01/11/2021
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