Dr. Stephen C Licetti, DO
Family Medicine in Ewing, New Jersey
1558508192- Practice location
- 34 Scotch RD Ste 1, Ewing, NJ 08628-2528
- Phone
- 609-498-7670
- Fax
- 609-385-4150
- Last updated
- September 2, 2020
Stephen Charles Licetti is a Family Medicine based in Ewing, NJ. Stephen Charles Licetti practices in Ewing, NJ and has the professional credentials of DO. The NPI Number for Stephen Charles Licetti is 1558508192 and holds a License No. 25MB08833000 (NJ). The current practice location address for Stephen Charles Licetti is 34 Scotch RD Ste 1, Ewing, NJ 08628-2528 and can be reached out via phone at 609-498-7670 and via fax at 609-385-4150.
Provider Profile Details
- NPI Number
- 1558508192
- Provider Name
- Stephen Charles Licetti
- Credential
- DO
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 34 Scotch RD Ste 1, Ewing, NJ 08628-2528
- Phone Number
- 609-498-7670
- Fax Number
- 609-385-4150
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 20, 2009
- Last Update Date
- September 2, 2020
- Certification Date
- September 2, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 34 Scotch RD Ste 1
Ewing, NJ 08628-2528 - City
- Ewing
- State
- New Jersey
- Zip
- 08628-2528
- Phone Number
- 609-498-7670
- Fax Number
- 609-385-4150
Provider Business Mailing Address Details
- Address
- 210 Yorktown Plz
Elkins Park, PA 19027-1424 - City
- Elkins Park
- State
- PA
- Zip
- 19027-1424
License Information
- License Number
- 25MB08833000
- License State
- NJ
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Stephen C Licetti, DO?
The NPI number of Dr. Stephen C Licetti, DO is 1558508192. It was assigned on January 20, 2009 and is currently active in the NPPES registry.
What is the specialty of Dr. Stephen C Licetti, DO?
Dr. Stephen C Licetti, DO is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number 25MB08833000.
Where does Dr. Stephen C Licetti, DO practice?
The practice location is 34 Scotch RD Ste 1, Ewing, NJ 08628-2528. The office can be reached at 609-498-7670 (phone) or 609-385-4150 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1558508192 directly on the NPPES registry website.