DANIEL J LICHT M.D. NPI 1023032539

NPI Information

NPI: 1023032539
Provider Name: DANIEL J LICHT, M.D.
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

PECOS Registration: Yes

Address:
3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - NEUROLOGY
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 590-1719
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Daniel J Licht, M.D. is a neurology with special qualifications in child neurology psychiatry neurology in Philadelphia, PA. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. Daniel J Licht, M.D. NPI is 1023032539. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - NEUROLOGY
PHILADELPHIA, PA
ZIP 19104-319
Phone: (215) 590-1719
Fax: (215) 590-1771

The NPI 1023032539 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 10/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		MD068489L	PENNSYLVANIA	No
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	MD068489L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	H61634	MEDICARE UPIN
2	057998	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA
3	8852804	MEDICAID	NEW JERSEY
4	001895942	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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