Organization
COXSACKIE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALVATORE LICCIARDI M.D. (PHYSICIAN)
(518) 731-7777
Entity
Organization
Contact information
Practice address
24 LAFAYETTE AVE, COXSACKIE, NY 12051-1305
(518) 731-7777
Mailing address
PO BOX 215, SLINGERLANDS, NY 12159-0215
(518) 731-7777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
169373
NY
Other
Enumeration date
10/18/2007
Last updated
11/28/2007
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