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1538172523
CHARLES J LICATA
BRISTOL, CT
NPI
1538172523
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CT 000359)
Enumeration Date
2006-08-14
Last Update Date
2007-07-08
Business Address
Dr. CHARLES J LICATA DO
625 CLARK AVE
BRISTOL, CT 06010-4068
Phone number: 860-583-7700
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Mailing Address
Dr. CHARLES J LICATA DO
4 FARM SPRINGS RD PROHEALTH PHYSICIANS
FARMINGTON, CT 06032-2573
Phone number: 860-284-5200
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