Provider Demographics
NPI:1194488387
Name:LIVECCHI, PATRICIA R
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:LIVECCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FLORHAM DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3628
Mailing Address - Country:US
Mailing Address - Phone:609-771-3630
Mailing Address - Fax:
Practice Address - Street 1:2 FLORHAM DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3628
Practice Address - Country:US
Practice Address - Phone:609-771-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00103400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist