Dr. Robert J Licul
Oral and Maxillofacial Pathology
959 Brush Hollow Rd
Westbury
, New York 11590-1778
Dr. Robert J Licul
Oral and Maxillofacial Pathology
959 Brush Hollow Rd
Westbury
, New York 11590-1778
(516) 333-5868
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Robert J Licul
- 959 Brush Hollow Rd
- Westbury, NY
- Zip : 11590-1778
- Fax : (516) 333-5868
- Phone : (516) 333-5900
Second Address
- Dr. Robert J Licul
- 959 Brush Hollow Rd
- Westbury, NY
- Zip : 11590-1778
- Fax : (516) 333-5868
- Phone : (516) 333-5900
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 044656 | NY |
National Provider Identifier
| NPI | 1700869765 |
|---|---|
| Provider Name | Dr. Robert J Licul |
| First Address | Westbury, NY 11590-1778 |
| Second Address | Westbury, NY 11590-1778 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/11/2005 |
| Last Update Date | 17/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02071410 | (05) | NY |
| U80973 | (02) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.