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NPI Code Detail

MEDICARE: MRS. LINDSEY MORGAN LICAK R.N.

MEDICARE:  MRS. LINDSEY MORGAN LICAK  R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse738490NY

General Provider Information

NPI Number : 1619472636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDSEY MORGAN LICAK R.N.
Provider Business Mailing Address
First Line : 1986 GILBERT RD
Second Line :
City : OVID
State : NY
Zip : 14521-9762
Country : US
Telephone Number : 607-765-1280
Fax Number :
Provider Business Practice Location Address
First Line : 1986 GILBERT RD
Second Line :
City : OVID
State : NY
Zip : 14521-9762
Country : US
Telephone Number : 607-765-1280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2018
Last Update Date : 03/30/2018

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Directions to “ MRS. LINDSEY MORGAN LICAK R.N.” Practice Location

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