Lico, Serrie C

Lico, Serrie C is an individual health care provider with primary practice located at 1330 Mercy Dr Nw Ste 101 , Canton OH 44708-2624. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Lico, Serrie C can be contacted via phone (330) 588-4676.

Contact Information

Primary practice address
1330 Mercy Dr Nw Ste 101 Canton OH 44708-2624
Phone: (330) 588-4676
Fax: (330) 588-4677
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 25MA10202300 New Jersey
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X MD068831L Pennsylvania
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 35.122143 Ohio

Profile Details

NPI number 1790746790
LBN Legal business name Lico, Serrie C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jun 17th, 2021 - about 4 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 1790746790 NPPES
New York MEDICAID 03112934

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