NPI 1831138189

Robert Licho, MD

Practitioner Nuclear Medicine Physician Worcester, MA

Practice location

Address: 55 Lake Ave N, Worcester, MA 01655-0002
Phone: (508) 334-7237
Fax: (774) 441-8443
Mailing address: PO Box 415348, Boston, MA 02241-5348

Registered specialties

Nuclear Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207U00000X Licence 72925 (MA)

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Registry record

NPI: 1831138189
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Jun 2006
Record last updated: 7 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.