Individual
ALFRED LICCIARDELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4023 JUNCTION BLVD, CORONA, NY 11368-2123
(718) 898-9833
(718) 898-9834
Mailing address
795 GARDEN ST, 5-O, BRONX, NY 10460-1130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
039203
NY
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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