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Individual

ERIKA LICCIARDONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1099 S TOWNSHIP BLVD, PITTSTON, PA 18640-3247
(570) 602-2400
Mailing address
438 MILWAUKEE AVE, OLD FORGE, PA 18518-1236
(570) 507-4761

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
10/28/2021
Last updated
10/28/2021
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