Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PIERRE L LICIN
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · NORTH BABYLON, NY
Registration Details
- NPI Number
- 1841443710
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 23, 2008 (17.495017738098 yrs)
- Last Updated
- Oct 23, 2008
- License
-
004355 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
15 EDDIE AVENORTH BABYLON, NY, 117032712Browse NY providers · Browse ZIP 11703
- Phone
- 6315862865
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.