MARTHA MARY KICAK


Address: 2105 W Genesee St, Syracuse, NY 13219-1656
Phone: 3154683239

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 164W00000X Licensed Practical Nurse 082747 NY Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 1609088871 05
NY LPN 082747 01

Office Location

Street Address 2105 W GENESEE ST
City SYRACUSE
State NY
Zip Code 13219-1656

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 164W00000X
Grouping Nursing Service Providers
Classification Licensed Practical Nurse

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City SYRACUSE
Zip Code 13219

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Dataset Information

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.

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