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1295768307
MARY ANN LICWINKO
PHILADELPHIA, PA
NPI
1295768307
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: PA 187701L)
Enumeration Date
2006-07-09
Last Update Date
2015-03-25
Business Address
-- MARY ANN LICWINKO CRNA
8835 GERMANTOWN AVE
PHILADELPHIA, PA 19118-2718
Phone number: 215-248-8200
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Mailing Address
-- MARY ANN LICWINKO CRNA
68 S SERVICE RD SUITE 350
MELVILLE, NY 11747-2358
Phone number: 516-945-3347
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