Coxsackie Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

169373 Issued in NY

Legal business name

COXSACKIE FAMILY PRACTICE

Practice address

24 Lafayette Ave
Coxsackie, NY 12051-1305

Phone

(518) 731-7777

NPI assigned

Oct 18, 2007

Last updated

Nov 28, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Salvatore Licciardi, M.D.NPI 1386608248

Title

Physician

Phone

(518) 731-7777

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Salvatore Licciardi

  • Family Medicine Physician
  • Coxsackie, NY
  • NPI 1386608248
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1114116845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "SLINGERLANDS",
            "state": "NY",
            "postal_code": "121590215",
            "telephone_number": "518-731-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LAFAYETTE AVE",
            "city": "COXSACKIE",
            "state": "NY",
            "postal_code": "120511305",
            "telephone_number": "518-731-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COXSACKIE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "LICCIARDI",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "518-731-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "169373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Abigide
• Bianca Lincon Barbour, LMSW
• Abigail Breen, R.N.
• Sara Collesides, NP
• Columbia Memorial Regional Medical PLLC
• Coxsackie Optometric PC (Coxsackie Eye Associates)
• Coxsackie Rescue Squad
• Coxsackie Transport, Inc.
• Coxsackie-Athens CSD
• Lynette Antonia Dalland, SLP

• Family Medicine Physician in Coxsackie, NY
• Providers in Coxsackie, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.