Ciccolari Micaldi, Susanna

Ciccolari Micaldi, Susanna is an sole proprietor health care provider with primary practice located at 1001 N. Minneapolis St , Wichita KS 67214-3127. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Ciccolari Micaldi, Susanna can be contacted via phone (316) 293-2647.

Contact Information

Primary practice address
1001 N. Minneapolis St Wichita KS 67214-3127
Phone: (316) 293-2647
Fax: (855) 476-0305
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 94-08402 Kansas
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 04-41077 Kansas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 94-08402 Kansas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 04-41077 Kansas

Profile Details

NPI number 1790190791
LBN Legal business name Ciccolari Micaldi, Susanna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2014
Last updated Jun 21st, 2023 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790190791 NPPES
Kansas MEDICAID 30004664320001

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