Provider Demographics
NPI:1538360581
Name:PICA, JOHN ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:PICA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LAKE ST
Mailing Address - Street 2:APT 2-H
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-4033
Mailing Address - Country:US
Mailing Address - Phone:914-645-2200
Mailing Address - Fax:
Practice Address - Street 1:11 SETON LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4128
Practice Address - Country:US
Practice Address - Phone:914-645-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008703-1111N00000X
NJ38MC00581900111N00000X
NY174400000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractor
No174400000XOther Service ProvidersSpecialist