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Contact Information

MICHAEL J DECICCO MD PLLC
200 NORTH ST
SUITE 301
GENEVA, NY14456-1561
 Phone: 315-787-5353
 Fax: 315-315-7875
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Facial Plastic Surgery

207YS0123X 04 Physician/Otolaryngology
 

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MICHAEL J DECICCO MD PLLC

NPI Number 1417099136
LBN Legal business name MICHAEL J DECICCO MD PLLC
Authorized official MICHAEL DECICCO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/12/2007
Last updated 08/22/2007 - About 19 years ago
Identifiers
NY License # 220674
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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