Paul Licata
Radiology, Vascular & Interventional Radiology in Lewisberry, PA. Individual provider (NPI-1).
NPI number1790772002
StatusActive
Last updated in NPPESMay 24, 2021
Details
- NPI
- 1790772002
- Entity type
- Individual (NPI-1)
- Name
- Paul Licata
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2005
- Last updated
- May 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0204X | Radiology, Vascular & Interventional Radiology | MD073064L | PA | Yes |
Practice location
629d Lowther RdSuite 3950
Lewisberry, PA 17339-9527
Phone 717-932-5200
Mailing address
629d Lowther RdSuite 3950
Lewisberry, PA 17339-9527
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All 7 Vascular & Interventional Radiology Physician providers in Lewisberry · All 121 providers in Lewisberry
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