Michael J Decicco MD Pllc

NPI #1417099136 in Geneva, New York

Provider Information

NPI Number: 1417099136
Entity Type: Organization
Organization Name: Michael J Decicco MD Pllc
Primary Specialty: Otolaryngology
Enumeration Date: Feb 12, 2007
Last Updated: Aug 22, 2007

Practice Location

Address: 200 NORTH ST
Address 2: SUITE 301
City: Geneva
State: New York
ZIP Code: 14456-1561
Phone: (315) 787-5353

Authorized Official

Name: DR. MICHAEL J DECICCO, MD
Title: OWNER
Phone: (315) 787-5353

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology - Pediatric Otolaryngology — Pediatric Otolaryngology	207YP0228X
Otolaryngology - Facial Plastic Surgery — Facial Plastic Surgery	207YS0123X
Otolaryngology	207Y00000X	Primary

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