Provider Demographics
NPI:1114467842
Name:LICEFIX, INC
Entity Type:Organization
Organization Name:LICEFIX, INC
Other - Org Name:LICENDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADELE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-759-5200
Mailing Address - Street 1:939 8TH AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4264
Mailing Address - Country:US
Mailing Address - Phone:212-759-5200
Mailing Address - Fax:
Practice Address - Street 1:227 E 81ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-3209
Practice Address - Country:US
Practice Address - Phone:212-759-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty