Individual ProviderMary SicilianoFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address755 Memorial Pkwy, Suite 300, Phillipsburg, NJ 08865-2748(908) 454-6303(908) 835-1910PECOS EnrollmentBased on the most recent information from CMS, provider Mary Siciliano is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1205834454Provider TypeIndividualFull NameSiciliano, MaryTitleDr.CredentialD.O.GenderFemaleSole ProprietorNoEnumeration Date7/12/2005Last Updated9/14/2015Contact InformationPractice LocationPractice Address755 Memorial Pkwy, Suite 300, Phillipsburg, NJ 08865-2748Phone(908) 454-6303Fax(908) 454-2289Mailing LocationMailing AddressPO Box 27957, Salt Lake City, UT 84127-0957Phone(908) 835-1910Fax(908) 835-1924Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMB62184New JerseyProvider IdentifiersIDDescriptionIssuerID7237308DescriptionMedicaidIssuerUnlistedNew Jersey