Licho, Robert
Licho, Robert is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nuclear Medicine, which is considered as his primary health care specialty. Licho, Robert can be contacted via phone (508) 334-7237.Contact Information
Primary practice address
55 Lake Ave N
Worcester MA 01655-0002
Phone: (508) 334-7237
Fax: (774) 441-8443
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | 72925 | Massachusetts |
Profile Details
| NPI number | 1831138189 |
|---|---|
| LBN Legal business name | Licho, Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jun 7th, 2021 - about 3 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 | 1831138189 | NPPES |
| Massachusetts | MEDICAID | 3067866 | |
| Massachusetts | MEDICAID | 110048901A |
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