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Dorin Liconti

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

Based on the most recent information from CMS, provider Dorin Liconti is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1306114228
Provider Type
Individual
Full Name
Liconti, Dorin
Credential
RPA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/6/2011
Last Updated
4/8/2022

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-8895

Unlisted Fax

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer New York

Dorin Liconti

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Youssef, Olivia Mary

Kane, Colleen Mary

Shkandriy, Tetyana

Cho, Eunice

Lavallee, David Norman

Perazzo, Marina

Raineri, Caterina O

Suarez, Michelle

Anees, Insherah

Lipnitskiy, Mona Trinette