Individual
DR. LAUREN AUDREY LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7575
Mailing address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7575
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
255MA08698600
NJ
208600000X
Surgery Physician
Primary
278537
NY
2086S0102X
Surgical Critical Care Physician
35123573
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105408
—
OH
05
—
04182261
—
NY
Enumeration date
05/20/2010
Last updated
11/12/2024
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