Individual
DR. GREG LICAMELI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-8851
Mailing address
265 FARM LN, WESTWOOD, MA 02090-1111
(781) 326-8404
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
161245
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3204618
—
MA
Enumeration date
02/07/2006
Last updated
07/08/2007
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