Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 182351 | NY |
NPI | 1447207527 |
---|---|
Provider Name | Frederick Licciardi |
First Address | New York, NY 10016-3214 |
Second Address | New York, NY 10016-3214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 12/02/2021 |