MARTHA MARY KICAK (NPI# 1104230317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104230317 |
| Entity Type | Individual |
| Full Name | MARTHA MARY KICAK |
| Credential | LPN |
| Practice Address |
2105 W Genesee St Syracuse NY 13219-1656 |
| Mailing Address |
4600 W Genesee St # 2105west Syracuse NY 13219-1707 |
| Practice Telephone | 3154683239 |
| Practice Fax Number | 3154682917 |
| Mailing Telephone | 3154683239 |
| Mailing Fax Number | 3154682917 |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 082747 | NY | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 1609088871 | 05 | |
| NY | LPN | 082747 | 01 |
| Street Address |
2105 W GENESEE ST |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13219-1656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902888142 | Peter W Calabrese | Podiatrist | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2005-11-15 |
| 1104360536 | Karen Gana | Acupuncturist | 2105 W Genesee St, Suite 209, Syracuse, NY 13219-1656 | 2016-12-03 |
| 1245605997 | Dr. P. Teluk, Dds, PC | Clinic/Center | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-12-07 |
| 1073981254 | Joeann Haste-bentley | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-09-04 |
| 1720469687 | Ashley Marie Vega | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2015-06-16 |
| 1891127254 | Joan W Diehl | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-08-07 |
| 1487090585 | Susan M Hanlon | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-05-15 |
| 1225377229 | Dianna C Torrisi | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1656 | 2013-02-11 |
| 1891032777 | Heather Lynn Longo | Licensed Practical Nurse | 2105 W Genesee St, Syracuse, NY 13219-1698 | 2013-01-11 |
| 1104171461 | Theo L Dean | Registered Nurse | 2105 W Genesee St, Syracuse, NY 13219-1698 | 2012-07-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972155125 | Claire A Conroy | Registered Nurse | Westhill High School, 4501 Onondaga Blvd, Syracuse, NY 13219 | 2019-07-09 |
| 1699339242 | Gia Ruffini | Licensed Practical Nurse | 212 South Terry Rd., Syracuse, NY 13219 | 2019-04-30 |
| 1629549373 | Amy Elisabeth Steigerwald | Registered Nurse | 400 Walberta Rd., Syracuse, NY 13219 | 2018-12-06 |
| 1073007670 | Bryan D. O'neil | Optometrist | 4109 W Genesee St Ste 100, Syracuse, NY 13219 | 2018-06-18 |
| 1801279732 | Podiatry Services of Central New York, PC | Podiatrist | 4623 Onondaga Blvd., Syracuse, NY 13219 | 2015-07-09 |
| 1699118893 | Christine Anne Marshall | Licensed Practical Nurse | 1604 West High Terrace, Syracuse, NY 13219 | 2013-04-08 |
| 1447596515 | Mary Lou Karrat | Social Worker | 4336 Fay Road, Syracuse, NY 13219 | 2012-12-18 |
| 1801193636 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3439 W. Genesee St., Ste. 300, Syracuse, NY 13219 | 2011-02-14 |
| 1053616904 | Ranz Consulting Goup | Preferred Provider Organization | 104 Watchower Ln, Syracuse, NY 13219 | 2011-01-24 |
| 1003123480 | Lisa Marie Searles | Occupational Therapist | 110 Elmtree Lane, Syracuse, NY 13219 | 2010-09-08 |
| Find all providers in zip 13219 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927848 | Gwendolyn Jane Thomas | Licensed Practical Nurse | 139 Hayden Ave, Syracuse, NY 13204-1509 | 2020-09-17 |
| 1780200758 | Stacey R Green | Licensed Practical Nurse | 707 Meadowbrook Dr, Syracuse, NY 13210-3113 | 2020-06-24 |
| 1033743539 | Mindy Joy Cottrell | Licensed Practical Nurse | 515 Florida Rd, Syracuse, NY 13211-1220 | 2020-02-24 |
| 1205474772 | Mary Kresser | Licensed Practical Nurse | 214 Lafayette Rd, Syracuse, NY 13205-2921 | 2019-12-16 |
| 1528602166 | Rebecca Anne Snyder | Licensed Practical Nurse | 510 Greenwood Pl, Syracuse, NY 13210-2526 | 2019-11-06 |
| 1386286094 | Wendolyn Alicia White | Licensed Practical Nurse | 304 Martin Luther King W, Syracuse, NY 13205-1023 | 2019-10-14 |
| 1609423516 | Kortia Poole | Licensed Practical Nurse | 4574 Onondaga Blvd Apt 38, Syracuse, NY 13219-3308 | 2019-08-25 |
| 1649822826 | Tyrone Lamont Hunter | Licensed Practical Nurse | 620 Erie Blvd W Ste 620erie, Syracuse, NY 13204-2445 | 2019-07-09 |
| 1265099378 | Trina Leigh-marie Stearns | Licensed Practical Nurse | 525 Mosley Drive, Syracuse, NY 13206 | 2019-05-23 |
| 1699339242 | Gia Ruffini | Licensed Practical Nurse | 212 South Terry Rd., Syracuse, NY 13219 | 2019-04-30 |
| Find all providers in SYRACUSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.