Active NPI
Joseph C Licata, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1467421040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 171051
- Practice address
- 186 E 76TH St
New York, NY 10021-2844 - Phone
- (212) 585-3329
- Fax
- (212) 585-3717
- NPI assigned
- Mar 16, 2006
- Last updated
- Feb 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 171051 | NY | Primary |
Addresses
Primary practice location
186 E 76TH St
New York, NY 10021-2844
Mailing address
1559 York Ave
New York, NY 10028
Phone (212) 585-3329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171051 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234137600000",
"number": "1467421040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1559 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10028",
"telephone_number": "212-585-3329",
"fax_number": "212-585-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "186 E 76TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212844",
"telephone_number": "212-585-3329",
"fax_number": "212-585-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICATA",
"first_name": "JOSEPH",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2009-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "171051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.