Licitra, Edward J
Licitra, Edward J is an individual health care provider with primary practice located at J2 Brier Hill Ct , East Brunswick NJ 08816-3340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Licitra, Edward J can be contacted via phone (732) 390-7750.Contact Information
Primary practice address
J2 Brier Hill Ct
East Brunswick NJ 08816-3340
Phone: (732) 390-7750
Fax: (732) 390-7725
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 25MA07301300 | New Jersey |
Profile Details
| NPI number | 1538139548 |
|---|---|
| LBN Legal business name | Licitra, Edward J |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | May 20th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538139548 | NPPES |
| New Jersey | MEDICAID | 0100650 | |
| New Jersey | Other | 1790396281 |
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