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1720332943
MICHAEL LICCESE
SMITHTOWN, NY
NPI
1720332943
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: NY 3806831)
Enumeration Date
2012-11-09
Last Update Date
2012-11-09
Business Address
Mr. MICHAEL LICCESE R.N.
5 WEATHERSTONE WAY
SMITHTOWN, NY 11787-2244
Phone number: 631-979-0424
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Mailing Address
Mr. MICHAEL LICCESE R.N.
5 WEATHERSTONE WAY
SMITHTOWN, NY 11787-2244
Phone number: 631-979-0424
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