Charles Liccese
NPI #1205546199 in East Meadow, New York
Provider Information
- NPI Number
- 1205546199
- Entity Type
- Individual
- Name
- Charles Liccese
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Dec 1, 2022
- Last Updated
- Sep 26, 2023
Practice Location
- Address
- 1816 ALBERMARLE AVE
- City
- East Meadow
- State
- New York
- ZIP Code
- 11554-1617
- Phone
- (516) 315-1641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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