Individual
DR. JOHN J. LICCARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 FORREST BLEND DRIVE, TITUSVILLE, NJ 08560-1316
(609) 883-3886
Mailing address
1 FORREST BLEND DRIVE, TITUSVILLE, NJ 08560-1316
(609) 883-3886
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD023263E
PA
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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