GAETANO JOSEPH LICATA (NPI# 1225083058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225083058 |
Entity Type | Individual |
Full Name | GAETANO JOSEPH LICATA |
Credential | M.D. |
Practice Address |
720 Blackburn Rd Sewickley PA 15143-1459 |
Mailing Address |
9226 Willoughby Rd Pittsburgh PA 15237-4522 |
Practice Telephone | 4127497076 |
Mailing Telephone | 4123673945 |
Enumeration Date | 2006-05-23 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MD421210 | PA | Allopathic & Osteopathic Physicians |
Street Address |
720 BLACKBURN RD |
City | SEWICKLEY |
State | PA |
Zip Code | 15143-1459 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063410785 | Denise Renee Ramponi | Nurse Practitioner | 720 Blackburn Rd, Emergency Department, Sewickley, PA 15143-1459 | 2005-07-07 |
1821572306 | Allison Nicole Lang | Physician Assistant | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2018-09-20 |
1689184962 | Heritage Valley Medical Group, Inc. | Emergency Medicine | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2017-10-02 |
1366982787 | Paige Edwards | Physician Assistant | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2017-03-04 |
1033651229 | Karina Alexandra Luttner | Registered Nurse | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2016-11-06 |
1922557669 | Carrera Reinheimer | Physician Assistant | 720 Blackburn Rd, Sewickley, PA 15143 | 2016-09-22 |
1437608155 | Aimee Wyant | Physician Assistant | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2016-09-22 |
1871961607 | Paul David Maniago | Nurse Practitioner | 720 Blackburn Rd, Sewickley Hospital - 4 Central, Sewickley, PA 15143-1459 | 2015-09-10 |
1538554696 | Megan Phillips | Emergency Medicine | 720 Blackburn Rd, Sewickley, PA 15143 | 2015-04-05 |
1659789402 | Lindsey Gilday | Physician Assistant | 720 Blackburn Rd, Sewickley, PA 15143-1459 | 2014-07-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679082713 | Annie Cares, Inc. | Case Management | 207 Timber Lane, Sewickley, PA 15143 | 2017-09-20 |
1083132617 | Andrew Wu | Specialist/Technologist | 1420 North Shevlin Court, Sewickley, PA 15143 | 2017-09-04 |
1619498706 | Marisa Lynn Ciamacca | Optometrist | 2591 Wexford Bayne Rd Ste 104, Sewickley, PA 15143 | 2017-06-29 |
1730619644 | Eva Marie Haddad | Physician Assistant | 2100 Georgetowne Drive, Suite 400, Sewickley, PA 15143 | 2017-06-13 |
1376098129 | Stephanie Harkins | Chiropractor | 1 Ohio River Blvd, Sewickley, PA 15143 | 2016-08-22 |
1710339692 | Kara Lynn Varga | Optometrist | 400 Broad Street Suite 2020, Sewickley, PA 15143 | 2016-07-05 |
1265890511 | Stacy Moon | Chiropractor | 2605 Nicholson Road, Building 3, Suite 120, Sewickley, PA 15143 | 2016-02-02 |
1003286857 | John Robert Utberg | Obstetrics & Gynecology | 210 Alagua Dr., Sewickley, PA 15143 | 2015-10-05 |
1588043434 | Simmons Chiropractic & Wellness | Chiropractor | 2425 Rochester Rd, Sewickley, PA 15143 | 2015-05-26 |
1316346042 | Lauri Lang | Dietitian, Registered | 2607 Nicholson Rd., Suite 2100, Building 2, Sewickley, PA 15143 | 2014-08-19 |
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Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306019658 | Kyle Thomas Kutrovac | Emergency Medicine | 720 Blackburn Rd, Department of Emergency Medicine, Sewickley, PA 15143-1459 | 2008-04-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053920645 | Ems Medical Care, LLC | Emergency Medicine | 347 N Pottstown Pike Ste 102, Exton, PA 19341-2222 | 2020-07-29 |
1275097156 | Sean Thomas Cook | Emergency Medicine | 421 College Park Dr, Monroeville, PA 15146-1535 | 2019-01-25 |
1821593849 | Nicole Ann Lollo | Emergency Medicine | 365 Spring Ave, Mars, PA 16046 | 2018-03-30 |
1326451758 | Earl David Morgan | Emergency Medicine | 5439 Rt 153, Brockport, PA 15823 | 2014-06-03 |
1073802112 | Elizabeth Guttman Sevin | Emergency Medicine | 400 Hidden River Rd, Penn Valley, PA 19072-1113 | 2011-03-29 |
1740414820 | Jason Becker | Emergency Medicine | 5501 Old York Road, Korman Basement, Tabor Emergency Physicians, Phila, PA 19141 | 2009-05-05 |
1477711190 | Brian J Clohessy | Emergency Medicine | Red Lion and Knights Road, Frankford Hospital, Philadelphia, PA 19114 | 2008-05-29 |
1720272818 | Maggie Beams | Emergency Medicine | 1218 Walnut St Apt 1003, Philadelphia, PA 19107-5446 | 2007-08-31 |
1336280296 | Thomas Baumgarten | Emergency Medicine | Cove Forge Road, Route 1, Williamsburg, PA 16693 | 2007-02-12 |
1407906613 | Mark William Van Dyke | Emergency Medicine | 306 W 11th St 2nd Fl, Erie, PA 16501-1705 | 2007-01-11 |
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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.