Individual
DR. PETER JOSEPH LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5410 W SAHARA AVE, LAS VEGAS, NV 89146-3307
(702) 362-2500
(702) 876-6581
Mailing address
5410 W SAHARA AVE, LAS VEGAS, NV 89146-3307
(702) 362-2500
(702) 876-6581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
315
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002566
—
NV
Enumeration date
10/27/2006
Last updated
09/16/2014
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