National Provider Identifier

Adam Licata

Adam Licata is listed in the NPPES registry with a primary specialty of Physical Therapist in Kenmore, NY and a listed phone number of (716) 423-2262.

NPI 1750266615Kenmore, NYPhysical Therapist

Profile Overview

NPI
1750266615
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
August 09, 2025
Last Updated
August 09, 2025

Practice Location

  • 2760 Delaware Avenue
  • Kenmore, NY 14217

Phone: (716) 423-2262

Mailing Address

  • 106 Shepard Avenue
  • Kenmore, NY 14217

Specialties

  • Physical Therapist (225100000X)
Full Record
NPI
1750266615
Entity Type
Individual
Last Name
Licata
First Name
Adam
Mailing Street Address
106 Shepard Avenue
Mailing City
Kenmore
Mailing State
NY
Mailing ZIP Code
14217
Mailing Country
US
Mailing Phone
(716) 578-4536
Practice Street Address
2760 Delaware Avenue
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217
Practice Country
US
Practice Phone
(716) 423-2262
Enumeration Date
August 09, 2025
Last Updated
August 09, 2025
Sex
Male
Sole Proprietor
Yes
Certification Date
August 07, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X)