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Jeffrey Licata, PA-C
NPI 1104385947 · on the registry since 2019
Practice
- Address
- 3333 Hylan Blvd
Staten Island, NY 10306 - Phone
- (718) 667-7500
- Organisation at this address
- True North Medical Group Pc
Orthopedic Associates Urgent CareInferred from a shared address, not stated in the registry. - Clinicians at this address
- 17
Additional practice sites
- 2 Center Plz, Tinton Falls, NJ
Registry record
- Primary taxonomy
- Medical Physician Assistant
363AM0700X
- Also registered as
- Medical Physician Assistant
- Licence states on file
- NJ, NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-12-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York