Patricia Licausi

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Frederica, DE

NPI 1477910099 · NPPES record last updated Jan 27, 2016

Key facts

NPI
1477910099
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
3148 Main Street
Frederica, DE 19946
Phone
(302) 724-9113
NPI assigned
Jan 27, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

3148 Main Street
Frederica, DE 19946

Mailing address

3148 Main St.
Frederica, DE 19946
Phone (302) 538-4183

Other providers in Frederica, DE

All providers in Frederica, DE · Student in an Organized Health Care Education/Training Program in Delaware

Sources for this page

Verify at the official NPI Registry.