Individual
MISS KAELYN ELIZABETH CICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
5800 HERITAGE LANDING DR STE C, EAST SYRACUSE, NY 13057-9378
(314) 445-2701
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3433
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
014312
NY
Other
Enumeration date
09/28/2010
Last updated
11/13/2023
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