Licznerski, Barbara Teresa

Licznerski, Barbara Teresa is an individual health care provider with primary practice located at 826 Washington St Suite 104, Watertown NY 13601-4065. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Licznerski, Barbara Teresa can be contacted via phone (315) 786-1500.

Contact Information

Primary practice address
826 Washington St Suite 104 Watertown NY 13601-4065
Phone: (315) 786-1500
Fax: (315) 786-2074
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 187504-1 New York

Profile Details

NPI number 1407825151
LBN Legal business name Licznerski, Barbara Teresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Jul 8th, 2007 - about 18 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 1407825151 NPPES
New York MEDICAID 01563780
New York Other 070012711
New York Other AA0167

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