Licata, Amy L

Licata, Amy L is an individual health care provider with primary practice located at 301 S 7Th Ave Suite 2020, West Reading PA 19611-1410. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Licata, Amy L can be contacted via phone (610) 375-6565.

Contact Information

Primary practice address
301 S 7Th Ave Suite 2020 West Reading PA 19611-1410
Phone: (610) 375-6565
Fax: (610) 375-2065
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X SP-007431 Pennsylvania

Profile Details

NPI number 1255393054
LBN Legal business name Licata, Amy L
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Aug 19th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255393054 NPPES
Pennsylvania MEDICAID 103102437

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