Decicco, Michael J
Decicco, Michael J is an sole proprietor health care provider with primary practice located at 200 North St Suite 301, Geneva NY 14456-1561. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Pediatric Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Decicco, Michael J can be contacted via phone (315) 787-5353.Contact Information
Primary practice address
200 North St Suite 301
Geneva NY 14456-1561
Phone: (315) 787-5353
Fax: (315) 787-5350
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Facial Plastic Surgery | 207YS0123X | 220674 | New York |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 220674 | New York |
| Allopathic & Osteopathic Physicians / Pediatric Otolaryngology | 207YP0228X | 220674 | New York |
Profile Details
| NPI number | 1255355202 |
|---|---|
| LBN Legal business name | Decicco, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Jul 6th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255355202 | NPPES |
| New York | MEDICAID | 02171671 |
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