National Provider Identifier
David S. Licata
David S. Licata is listed in the NPPES registry with a primary specialty of Optician in Williamsville, NY and a listed phone number of (716) 631-3860.
Profile Overview
- NPI
- 1922136464
- Provider Type
- Individual
- Primary Specialty
- Optician
- Enumeration Date
- February 28, 2007
- Last Updated
- December 20, 2007
Practice Location
- 8070 Transit RD
- Williamsville, NY 14221-4116
Phone: (716) 631-3860
Specialties
- Optician (156FX1800X)
Full Record
- NPI
- 1922136464
- Entity Type
- Individual
- Last Name
- Licata
- First Name
- David
- Middle Name
- S.
- Name Prefix
- Mr.
- Mailing Street Address
- 8070 Transit RD
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-4116
- Mailing Country
- US
- Mailing Phone
- (716) 631-3860
- Practice Street Address
- 8070 Transit RD
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-4116
- Practice Country
- US
- Practice Phone
- (716) 631-3860
- Practice Fax
- (716) 631-3860
- Enumeration Date
- February 28, 2007
- Last Updated
- December 20, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optician (156FX1800X)
- Other Identifiers
- 000300065003 (NY, Blue Cross/Blue Shield), 333691 (NY, Nva), 000300065001 (NY, Blue Cross/Blue Shield), 333541 (NY, Nva), 46032 (NY, Spectera), 46028 (NY, Spectera), 00026918201 (NY, Univera), 7310246 (NY, Independent Health), 000528441002 (NY, Community Blue), OP2234-01 (NY, Eyemed), OP2234-02 (NY, Eyemed), 0007025821 (NY, Aetna)