Individual
DANIEL LICAMARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 HAMBURG TPKE, WAYNE, NJ 07470-3235
(973) 559-4056
(973) 710-1059
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00386400
NJ
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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