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NPI Code Detail

MEDICARE: ANTHONY LICATA M.D.

MEDICARE: ANTHONY LICATA M.D.
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
1207RC0000XCardiovascular Disease PhysicianMD-071014-LPA
2207RC0000XCardiovascular Disease PhysicianMD071014LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588643993
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY LICATA M.D.
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number :
Provider Business Practice Location Address
First Line : 140 N POINTE BLVD
Second Line :
City : LANCASTER
State : PA
Zip : 17601-4132
Country : US
Telephone Number : 717-291-0700
Fax Number : 717-207-8626
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 09/17/2024

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Directions to “ ANTHONY LICATA M.D.” Practice Location

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