DR. PAUL LICATA (NPI# 1790772002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790772002 |
| Entity Type | Individual |
| Full Name | DR. PAUL LICATA |
| Credential | MD |
| Practice Address |
629d Lowther Rd Lewisberry PA 17339-9527 |
| Practice Telephone | 7179325200 |
| Practice Fax Number | 7179323095 |
| Mailing Telephone | 7179325200 |
| Mailing Fax Number | 7179323095 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2012-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD073064L | PA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MD073064L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 101097893 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036981 | Paul J Licata | Internal Medicine | 492 Montauk Ave, New London, CT 06320-4615 | 2005-07-07 |
| 1740361518 | Paul John Licata | Family Medicine | 1717 E Lincoln Ave, Anaheim, CA 92805-4345 | 2006-10-18 |
| 1336187996 | Paul Anthony Licata | Physician Assistant | 601 N Flamingo Rd, Pembroke Pines, FL 33028-1015 | 2006-06-03 |
| Street Address |
629D LOWTHER RD |
| City | LEWISBERRY |
| State | PA |
| Zip Code | 17339-9527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750377818 | George Stephen Durisek | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2005-09-23 |
| 1538548334 | Jeremy Michael Ortiz | Physician Assistant | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2015-05-26 |
| 1548657141 | Quantum Imaging and Therapeutic Associates, Inc. | Physician Assistant | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2015-04-21 |
| 1548501026 | Quantum Imaging & Therapeutic Associates, Inc | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2013-03-08 |
| 1033345061 | Michael J. Graybill | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2009-06-04 |
| 1114161643 | Michael Mccollum | Radiology | 629d Lowther Rd, Lewisberry, PA 17339 | 2009-04-28 |
| 1487805115 | Kenneth L Jusko | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2008-09-30 |
| 1669675286 | Kelechi Princewill | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2007-06-10 |
| 1154533313 | Jason L Pennypacker | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2007-05-03 |
| 1093938367 | Patricia Barry-lane | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2007-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851525356 | Lewisberry Community Fire Company | Emergency Response System Companies | 105 West Front Street, Lewisberry, PA 17339 | 2009-05-12 |
| 1841386463 | Michael M Ryan | Family Medicine | 308 Market Street, Lewisberry, PA 17339 | 2006-10-04 |
| 1699793604 | Christopher Leon Smith | Radiology | 629d Lowther Rd., Lewisberry, PA 17339-2999 | 2006-07-17 |
| 1942625454 | Luellen Lee Gibbons | Speech-Language Pathologist | 7895 Bull Rd, Lewisberry, PA 17339-8850 | 2014-02-20 |
| 1740627678 | Glen E Santos | Pharmacist | 800 Stonybrook Ln, Lewisberry, PA 17339-8919 | 2013-06-02 |
| 1760921191 | Mellissa Thomas | Counselor | 909 Silver Lake Rd, Lewisberry, PA 17339-9117 | 2017-02-17 |
| 1205032851 | Benjamin Y Lee | Radiology | 629d Lowther Rd., Lewisberry, PA 17339-9222 | 2007-06-21 |
| 1841354529 | Family First Health Corporation | Clinic/Center | 308 Market St, Lewisberry, PA 17339-9257 | 2006-12-20 |
| 1366435232 | Robert Guido Michelini | Family Medicine | 689 Yorktown Rd, Lewisberry, PA 17339-9258 | 2005-08-25 |
| 1134688740 | Daulton Troy Rutter | Physical Therapist | 689 Yorktown Rd, Lewisberry, PA 17339-9258 | 2019-03-14 |
| Find all providers in zip 17339 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669930798 | Mvc Pa Pllc | Radiology | 4262 Old William Penn Hwy Ste 209, Murrysville, PA 15668-1954 | 2019-03-07 |
| 1205296209 | Interventional Solutions Inc. | Radiology | 333 Allegheny Ave Ste 200, Oakmont, PA 15139-2072 | 2016-03-03 |
| 1861857906 | Lehigh Valley Vascular Institute LLC | Radiology | 3450 High Point Blvd, Bethlehem, PA 18017-7801 | 2015-12-16 |
| 1447647102 | Fresenius Vascular Care Pottstown LLC | Radiology | 2217 E High St, Pottstown, PA 19464-3215 | 2015-04-21 |
| 1891119764 | Aaron Shiloh, Md LLC | Radiology | 715 Cherry Ln, Suite 100, Southampton, PA 18966-3936 | 2014-02-12 |
| 1396081857 | Shante D Bennett | Radiology | 503 North 21st St, Camp Hill, PA 17011 | 2013-01-02 |
| 1326310806 | Pa Vascular Institute LLC | Radiology | 505 Independence Rd Ste E, East Stroudsburg, PA 18301-7916 | 2012-01-31 |
| 1699090654 | Guillaume Boiteau | Radiology | 220 S Home Ave, Apt # 404, Pittsburgh, PA 15202-2844 | 2010-04-02 |
| 1184854531 | John Yoon | Radiology | 9 N 9th St Unit 510, Philadelphia, PA 19107-3154 | 2009-07-20 |
| 1831353879 | Pennsylvania Phlebology Group PC | Radiology | 707 Eagleview Blvd Ste 303, Exton, PA 19341-1159 | 2008-07-17 |
| Find all providers with the same taxonomy | ||||
| City | LEWISBERRY |
| Zip Code | 17339 |
Please comment or provide details below to improve the information on DR. PAUL LICATA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.