Licata, Michael
Licata, Michael is an individual health care provider with primary practice located at 2157 Main St , Buffalo NY 14214-2648. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Body Imaging is his primary health care specialty. Licata, Michael can be contacted via phone (716) 649-9000.Contact Information
Primary practice address
2157 Main St
Buffalo NY 14214-2648
Phone: (716) 649-9000
Fax: (716) 649-9005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 184241-1 | New York |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 184241 | New York |
Profile Details
| NPI number | 1306814579 |
|---|---|
| LBN Legal business name | Licata, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Sep 16th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306814579 | NPPES |
| New York | Other | 00026372703 | UNIVERA HEALTHCARE |
| New York | Other | 300080525 | UNIVERA HEALTHCARE |
| New York | Other | 040426000284 | UNIVERA HEALTHCARE |
| New York | Other | 113586FF | UNIVERA HEALTHCARE |
| New York | Other | 1609206 | UNIVERA HEALTHCARE |
| New York | MEDICAID | 01528734 | UNIVERA HEALTHCARE |
| New York | Other | 000523460013 | UNIVERA HEALTHCARE |
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