Individual provider · Type 1 NPI

Jeffrey Paul Licata, PA-C

Medical Physician Assistant · Staten Island, NY

NPI number 1104385947 Active

Practice location

3333 Hylan Blvd
Staten Island, NY 10306-3608

Call (718) 667-7500 Map

Other practice locations

  • 2 Center Plz, Tinton Falls, NJ 07724-9744 · (732) 673-5131

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X25MP00516300 (NJ)
Medical Physician Assistant Primary 363AM0700X031134 (NY)

Medical Physician Assistant: Definition to come...

18 other providers at this address

Other medical physician assistant providers in Staten Island

See all in Staten Island →

About NPI 1104385947

Jeffrey Paul Licata, PA-C's National Provider Identifier is 1104385947, issued on Mar 19, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Staten Island, NY. The record was last updated on Dec 19, 2023.