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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1255355202 NPPES
New York MEDICAID 02171671

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