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Martha Mary Kicak, LPN
Licensed Practical Nurse in Syracuse, New York
NPI 1104230317

Martha Mary Kicak is a Licensed Practical Nurse based in Syracuse, NY. Martha Mary Kicak practices in Syracuse, NY and has the professional credentials of LPN. The NPI Number for Martha Mary Kicak is 1104230317 and holds a License No. 082747 (New York).

The current practice location address for Martha Mary Kicak is 2105 W Genesee St, Syracuse, NY and can be reached out via phone at 315-468-3239 and via fax at 315-468-2917.

Location: 2105 W Genesee St, Syracuse, NY, 13219-1707
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104230317
Provider Name
Martha Mary Kicak
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
2105 W Genesee St, Syracuse, NY, 13219-1707
Phone Number
315-468-3239
Fax Number
315-468-2917
Provider Enumeration Date
06/16/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
082747 01 NY LPN
1609088871 05 NY
institution
Provider Business Practice Location Address Details
Address
2105 W Genesee St
City
Syracuse
State
New York
Zip
13219-1656
Phone Number
315-468-3239
Fax Number
315-468-2917
person
Provider Business Mailing Address Details
Address
2105 W Genesee St
City
Syracuse
State
New York
Zip
13219-1656
Phone Number
315-468-3239
Fax Number
315-468-2917
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
082747 (New York)
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.
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