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Barbara Teresa Licznerski, MD
Specialist in Watertown, New York
NPI 1407825151

Barbara Teresa Licznerski is a Specialist based in Watertown, NY. Barbara Teresa Licznerski practices in Watertown, NY and has the professional credentials of MD. The NPI Number for Barbara Teresa Licznerski is 1407825151 and holds a License No. 187504-1 (New York).

The current practice location address for Barbara Teresa Licznerski is 826 Washington St, Watertown, NY and can be reached out via phone at 315-786-1500 and via fax at 315-786-2074.

Location: 826 Washington St, Watertown, NY, 13601-4065
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407825151
Provider Name
Barbara Teresa Licznerski
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
826 Washington St, Watertown, NY, 13601-4065
Phone Number
315-786-1500
Fax Number
315-786-2074
Provider Enumeration Date
03/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01563780 05 NY
070012711 01 NY RAILROAD MEDICARE
AA0167 01 NY GROUP NUMBER
institution
Provider Business Practice Location Address Details
Address
826 Washington St
City
Watertown
State
New York
Zip
13601-4065
Phone Number
315-786-1500
Fax Number
315-786-2074
person
Provider Business Mailing Address Details
Address
826 Washington St
City
Watertown
State
New York
Zip
13601-4065
Phone Number
315-786-1500
Fax Number
315-786-2074
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
187504-1 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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