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Contact Information

PAUL J LICATA, DO
492 MONTAUK AVE
NEW LONDON, CT06320-4615
 Phone: 860-443-0305
 Fax: 860-443-0823
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PAUL J LICATA · (Male)

NPI Number 1225036981
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/07/2005
Last updated 06/23/2025 - About 12 months ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 000413
  • RI License # DO00565
  • CT Medicaid 001004134
  • CT Medicaid 004242707
  • RI Medicaid PL52716
Hospital affiliation(s)
  • LAWRENCE & MEMORIAL HOSPITAL - (Acute Care)
    365 MONTAUK AVE
    NEW LONDON, CT 06320
  • LAWRENCE & MEMORIAL HOSPITAL - (Acute Care)
    365 MONTAUK AVE
    NEW LONDON, CT 06320
  • WESTERLY HOSPITAL - (Acute Care)
    25 WELLS STREET
    WESTERLY, RI 02891
  • WESTERLY HOSPITAL - (Acute Care)
    25 WELLS STREET
    WESTERLY, RI 02891
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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