Individual
DR. SALVATORE LICCIARDONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
74 PASCACK RD, PARK RIDGE, NJ 07656-1935
(201) 391-4166
Mailing address
1319 WICKFORD LN, LANOKA HARBOR, NJ 08734-2912
(609) 242-0073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB02322300
NJ
Other
Enumeration date
05/19/2006
Last updated
10/14/2010
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