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Individual

MR. DAVID S. LICATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8070 TRANSIT RD, WILLIAMSVILLE, NY 14221-4116
(716) 631-3860
(716) 631-3860
Mailing address
8070 TRANSIT RD, WILLIAMSVILLE, NY 14221-4116
(716) 631-3860

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C004881-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026918201
UNIVERA
NY
01
000300065001
BLUE CROSS/BLUE SHIELD
NY
01
000300065003
BLUE CROSS/BLUE SHIELD
NY
01
000528441002
COMMUNITY BLUE
NY
01
0007025821
AETNA
NY
01
333541
NVA
NY
01
333691
NVA
NY
01
46028
SPECTERA
NY
01
46032
SPECTERA
NY
01
7310246
INDEPENDENT HEALTH
NY
01
OP2234-01
EYEMED
NY
01
OP2234-02
EYEMED
NY
Enumeration date
02/28/2007
Last updated
12/20/2007
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