Individual
DR. PAUL J LICATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
492 MONTAUK AVE, NEW LONDON, CT 06320-4615
(860) 443-0305
(860) 443-0823
Mailing address
492 MONTAUK AVE, NEW LONDON, CT 06320-4615
(860) 443-0305
(860) 443-0823
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
000413
CT
207RP1001X
Pulmonary Disease Physician
DO00565
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004134
—
CT
05
—
004242707
—
CT
05
—
PL52716
—
RI
Enumeration date
07/07/2005
Last updated
06/23/2025
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