Individual
KIMBERLY ANN LICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
764 2ND ST, MANCHESTER, NH 03102-5210
(603) 669-3925
Mailing address
764 2ND ST, MANCHESTER, NH 03102-5210
(603) 669-3925
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14856
NH
208600000X
Surgery Physician
MT188086
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/12/2007
Last updated
07/08/2024
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