Individual
MARISSA A. LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
270-05 76TH AVENUE, SUITE 103, NEW HYDE PARK, NY 11040
(516) 881-7060
Mailing address
7 HASTINGS DR, MERRICK, NY 11566-1442
(212) 346-9161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
877337
—
Other
Enumeration date
03/29/2006
Last updated
07/27/2016
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