MARK STEPHEN LICCINI (NPI# 1861562779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861562779 |
| Entity Type | Individual |
| Full Name | MARK STEPHEN LICCINI |
| Credential | DO |
| Practice Address |
31 Wimbledon Way Marlton NJ 08053-2087 |
| Practice Telephone | 2152054231 |
| Mailing Telephone | 2152054231 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 25MB 07743500 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
31 WIMBLEDON WAY |
| City | MARLTON |
| State | NJ |
| Zip Code | 08053-2087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619509288 | South Jersey Coping Clinic | Counselor | 525 Nj Route 73 South, Ste 306, Marlton, NJ 08053 | 2020-02-11 |
| 1780216952 | Aba Residential | Psychologist | 7 Cooper Ave Suit A, Marlton, NJ 08053 | 2020-02-06 |
| 1003447400 | Forrest Mark Waterman | Optometrist | 928 Nj-73, Evesham Township, NJ 08053 | 2020-02-04 |
| 1124666862 | Bh Brightview Greentree Opco, LLC | Alzheimer Center (Dementia Center) | 170 Grrentree Road, Marlton, NJ 08053 | 2019-12-12 |
| 1780226597 | Cassandra Ann Pistorius | Counselor | 77 Lakeside Dr, Marlton, NJ 08053 | 2019-10-14 |
| 1265099741 | Jessica Strassle | Occupational Therapist | 751 Nj-73, Suite 1, Marlton, NJ 08053 | 2019-05-21 |
| 1972169902 | Jefferson University Radiology Associates, LLC | Radiology | 999 Nj-73, # 101, Marlton, NJ 08053 | 2019-05-15 |
| 1235692120 | Liberty Corner Surgical Center At Marlton LLC | Clinic/Center | 95 Marlton Pike West, Marlton, NJ 08053 | 2019-04-09 |
| 1063995769 | Genesis Counseling Center, Inc. | Counselor | 2003 C Lincoln Dr. W., Marlton, NJ 08053 | 2018-09-10 |
| 1659853414 | Erika V Colbert | Nurse Practitioner | 1 Eves Drive 134, 134, Marlton, NJ 08053 | 2018-08-29 |
| Find all providers in zip 08053 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770718710 | Patrick Oconnor | Anesthesiology | 90 Brick Road, Virtua West Jersey Hospital, Marlton, NJ 08053-2177 | 2009-05-20 |
| 1518189919 | Terence W Murphy Md Pa | Anesthesiology | 1 Greentree Ctr, Suite 301, Marlton, NJ 08053 | 2007-05-03 |
| 1154338556 | Brian Chu | Anesthesiology | 5000 Sagemore Dr, Marlton, NJ 08053-4307 | 2006-08-01 |
| 1649226515 | Virtua Medical Group, Pa | Anesthesiology | 301 Lippincott Dr Ste 410, Marlton, NJ 08053-4197 | 2006-05-25 |
| 1932108727 | Andre M Pierre | Anesthesiology | 102e Centre Blvd, Marlton, NJ 08053-4129 | 2005-07-14 |
| 1952309940 | Frank J Iula | Anesthesiology | 102 Centre Blvd, Marlton, NJ 08053-4129 | 2005-07-13 |
| 1134127111 | David P Avella | Anesthesiology | 102 E Centre Blvd, Marlton, NJ 08053-4129 | 2005-07-13 |
| 1679571657 | Peter G. Sperandio | Anesthesiology | 102 E Centre Blvd., Marlton, NJ 08053-4129 | 2005-07-13 |
| 1972803864 | Demetrius Karanzalis | Anesthesiology | 102 Centre Blvd, Marlton, NJ 08053-4129 | 2010-10-26 |
| 1043538424 | Michael Ryan Pascarella | Anesthesiology | 102e Centre Blvd, Marlton, NJ 08053 | 2010-05-11 |
| Find all providers in MARLTON | ||||
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| 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.