Licitra, Edward J

Licitra, Edward J is an individual health care provider with primary practice located at J2 Brier Hill Ct , East Brunswick NJ 08816-3340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Licitra, Edward J can be contacted via phone (732) 390-7750.

Contact Information

Primary practice address
J2 Brier Hill Ct East Brunswick NJ 08816-3340
Phone: (732) 390-7750
Fax: (732) 390-7725
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 25MA07301300 New Jersey

Profile Details

NPI number 1538139548
LBN Legal business name Licitra, Edward J
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated May 20th, 2023 - about 2 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 1538139548 NPPES
New Jersey MEDICAID 0100650
New Jersey Other 1790396281

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