DR. PAUL J LICATA (NPI# 1225036981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225036981 |
| Entity Type | Individual |
| Full Name | DR. PAUL J LICATA |
| Credential | D.O. |
| Practice Address |
492 Montauk Ave New London CT 06320-4615 |
| Practice Telephone | 8604430305 |
| Practice Fax Number | 8604430823 |
| Mailing Telephone | 8604430305 |
| Mailing Fax Number | 8604430823 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-10-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
000413 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001004134 | 05 | |
| RI | PL52716 | 05 | |
| CT | 004242707 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740361518 | Paul John Licata | Family Medicine | 1717 E Lincoln Ave, Anaheim, CA 92805-4345 | 2006-10-18 |
| 1336187996 | Paul Anthony Licata | Physician Assistant | 601 N Flamingo Rd, Pembroke Pines, FL 33028-1015 | 2006-06-03 |
| 1790772002 | Paul Licata | Radiology | 629d Lowther Rd, Lewisberry, PA 17339-9527 | 2005-10-03 |
| Street Address |
492 MONTAUK AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-4615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760623037 | Roxanne L. Turturro | Social Worker | 492 Montauk Ave, New London, CT 06320-4615 | 2009-03-17 |
| 1285816314 | Gold Coast Pulmonary and Sleep Assoc | Nurse Practitioner | 492 Montauk Ave, New London, CT 06320-4615 | 2007-11-30 |
| 1821180621 | Gold Coast Pulmonary and Sleep Associates, LLC | Internal Medicine | 492 Montauk Ave, New London, CT 06320-4615 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295754273 | Southeastern Pulmonary Assoc. PC | Internal Medicine | 155 Montauk Avenue, New London, CT 06320 | 2006-07-19 |
| 1396804654 | Shoreline Pulmonary Associates LLC | Internal Medicine | 415 Ocean Ave, New London, CT 06320-4716 | 2006-12-06 |
| 1821180621 | Gold Coast Pulmonary and Sleep Associates, LLC | Internal Medicine | 492 Montauk Ave, New London, CT 06320-4615 | 2006-09-29 |
| 1720181209 | John S Urbanetti | Internal Medicine | 155 Montauk Avenue, New London, CT 06320 | 2006-09-07 |
| 1154436483 | Robert J Keltner | Internal Medicine | 155 Montauk Avenue, New London, CT 06320 | 2006-08-19 |
| 1275543043 | Louis V Buckley | Internal Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2006-08-08 |
| 1831108380 | Alan L Bier | Internal Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356761290 | Issahar Ben-dov | Internal Medicine | 300 Cedar St, Pulmonary &critical Care Section, Tac-441 South, New Haven, CT 06520-8057 | 2014-04-18 |
| 1669710216 | Arthur Christian Degraff Jr. | Internal Medicine | 160 Hunter Dr, West Hartford, CT 06107-1017 | 2013-01-16 |
| 1215287214 | Craig Stephen Conoscenti | Internal Medicine | 199 Gregory Blvd, Unit I5, Norwalk, CT 06855-2640 | 2012-09-17 |
| 1396024980 | Johan Van Jaarsveld | Internal Medicine | 81 Deer Run Rd, Woodbridge, CT 06525-1907 | 2011-08-12 |
| 1215143953 | Kaiser Toosy | Internal Medicine | 136 Sherman Ave Ste 302, New Haven, CT 06511-5210 | 2007-05-16 |
| 1477675098 | A. Joel Papowitz | Internal Medicine | 179 Pine Creek Ave, Fairfield, CT 06824-6341 | 2007-04-04 |
| 1639293186 | Thinesh Dahanayake | Internal Medicine | 330 Washington St Ste 430, Norwich, CT 06360-2700 | 2007-03-19 |
| 1104910215 | Christopher Edward Manfredi | Internal Medicine | 30 Stevens Street, Suite C, Norwalk, CT 06850 | 2006-10-03 |
| 1598869596 | Kanagaratnam Jegathesan Md PC | Internal Medicine | 2271 East Main St, Waterbury, CT 06705 | 2006-09-11 |
| 1497859409 | Kanagaratnam Jegathesan | Internal Medicine | 2271 East Main Street, Waterbury, CT 06705 | 2006-09-11 |
| Find all providers with the same taxonomy | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.