Individual ProviderNicole AlicinoPsychologistBehavioral Health & Social Service ProvidersPractice Address460 West 34th Street, 9th Floor, New York, NY 10001(212) 273-6519(732) 309-0991PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Alicino is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1487087169Provider TypeIndividualFull NameAlicino, NicoleTitleDr.CredentialPHDGenderFemaleSole ProprietorYesEnumeration Date8/16/2013Last Updated8/13/2019Contact InformationPractice LocationPractice Address460 West 34th Street, 9th Floor, New York, NY 10001Phone(212) 273-6519FaxUnlisted FaxMailing LocationMailing Address303 5th Ave Rm 1003, New York, NY 10016-6639Phone(732) 309-0991FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103TS0200XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode103T00000XDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense022720New YorkProvider IdentifiersIDDescriptionIssuerID022720DescriptionOtherIssuerNYS LICENSENew York