Individual
DR. GREGORY THOMAS SICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 W 17TH ST, APT 9D, NEW YORK, NY 10011-5374
(617) 645-4167
Mailing address
201 W 17TH ST, APT 9D, NEW YORK, NY 10011-5374
(617) 645-4167
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
170474-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
170474-1
NY
2085U0001X
Diagnostic Ultrasound Physician
170474-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02194681
—
NY
05
—
3095657
—
MA
Enumeration date
01/30/2006
Last updated
09/13/2013
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