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Ms. Maryanna Licata, NP
Family Nurse Practitioner in Valley Stream, New York
NPI 1336515808

Maryanna Licata is a Family Nurse Practitioner based in Valley Stream, NY and is specialized in Family. Maryanna Licata practices in Valley Stream, NY and has the professional credentials of NP. The NPI Number for Maryanna Licata is 1336515808 and holds a License No. F331097-1 (New York).

The current practice location address for Maryanna Licata is 1605 Southern Dr, Valley Stream, NY and can be reached out via phone at 516-526-2623.

Location: 1605 Southern Dr, Valley Stream, NY, 11580-1237
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336515808
Provider Name
Maryanna Licata
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1605 Southern Dr, Valley Stream, NY, 11580-1237
Phone Number
516-526-2623
Fax Number
Provider Enumeration Date
08/19/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1605 Southern Dr
City
Valley Stream
State
New York
Zip
11580-1237
Phone Number
516-526-2623
Fax Number
person
Provider Business Mailing Address Details
Address
1605 Southern Dr
City
Valley Stream
State
New York
Zip
11580-1237
Phone Number
516-526-2623
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
F331097-1 (New York)
Definition
Definition to come...
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