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1861562779
MARK STEPHEN LICCINI
VOORHEES, NJ
NPI
1861562779
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207L00000X Anesthesiology
(Licence: NJ 25MB 07743500)
Enumeration Date
2006-11-08
Last Update Date
2024-02-05
Business Address
MARK STEPHEN LICCINI DO
93 COOPER RD STE 100
VOORHEES, NJ 08043-4910
Phone number: 856-770-1920
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Mailing Address
MARK STEPHEN LICCINI DO
31 WIMBLEDON WAY
MARLTON, NJ 08053-2087
Phone number: 215-205-4231
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