Individual
MRS. ALISSA A. LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
410 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1101
(516) 465-3270
Mailing address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 796-8444
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
162005
—
174N00000X
Lactation Consultant (Non-RN)
—
—
363LF0000X
Family Nurse Practitioner
337734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162005
IBCLC
—
Enumeration date
04/02/2013
Last updated
01/24/2020
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