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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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