MR. Joseph Anthony Licausi II

NPI #1871112839 in West Haven, Connecticut

Provider Information

NPI Number: 1871112839
Entity Type: Individual
Name: MR. Joseph Anthony Licausi II
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician
Enumeration Date: Apr 10, 2020
Last Updated: Apr 10, 2020

Practice Location

Address: 950 CAMPBELL AVE
City: West Haven
State: Connecticut
ZIP Code: 06516-2770
Phone: (203) 932-5711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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